Sydney C Theobald, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

103761 Issued in NY

Practice address

595 W Main St
Watertown, NY 13601-1335

Phone

(888) 585-2228

NPI assigned

Feb 23, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1659079127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011335",
            "telephone_number": "888-585-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "SYDNEY",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2026-09-03",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "103761",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "P120209",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "119210",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Mental Health Association in Jefferson County, Inc.
• The Potter'S Place
• The Rowland Center, Inc.
• The Treehouse Hourly Child Care, LLC
• The Young Men'S Christian Association of Watertown Ny Inc.
• Adrean Lynn Thomas, OTD, OTR/L
• Courtney Leigh Thomas, M.A., CCC-SLP
• Jessica Lynn Thomas, RN
• Joseph Dean Thomas, MSW
• Linda Austin Thomas, MA

• Clinical Social Worker in Watertown, NY
• Providers in Watertown, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.