Sydney Leigh Doherty, LICSW
Individual provider Active NPI Clinical Social Worker · Fircrest, WA
NPI 1689334096 · NPPES record last updated Dec 27, 2021
Key facts
- NPI
- 1689334096
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LW61176154 (WA)
- Practice address
- 507 Spring St
Fircrest, WA 98466-6928 - Phone
- (253) 232-4853
- NPI assigned
- Dec 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW61176154 | WA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recenter Self | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW61176154 | WA | Yes |
Addresses
Primary practice location
507 Spring St
Fircrest, WA 98466-6928
Mailing address
507 Spring St
Fircrest, WA 98466-6928
Phone (253) 232-4853
Other providers in Fircrest, WA
- Bruce Gerard Davies
- Paul E Debusschere
- Alexander Miles Dermody
- Joy Michelle Derriso
- Gail Diprete
- DT Smith Healthgroup PLLC
- Kelly Ebels
- Emerson Dental Inc PC
- Maricris Pang Espino
- Jennifer Marie Evinger
All providers in Fircrest, WA · Clinical Social Worker in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.