Individual provider Active NPI

Sydney Poineau, LMSW

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1750928107
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
525 W 14TH St Unit D
Traverse City, MI 49684-4061
Phone
(231) 714-0282
NPI assigned
Dec 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 680110579 MI
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

525 W 14TH St Unit D
Traverse City, MI 49684-4061

Mailing address

525 W 14TH St Unit D
Traverse City, MI 49684-4061
Phone (231) 714-0282

Other practice location 1

1010 S Garfield Ave
Traverse City, MI 49686-3434
Phone (231) 409-4566

Other names 1

  • Sydney Wendels Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
680110579MIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1750928107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W 14TH ST UNIT D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844061",
            "telephone_number": "231-714-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W 14TH ST UNIT D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844061",
            "telephone_number": "231-714-0282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 S Garfield Ave",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496863434",
            "country_code": "US",
            "telephone_number": "231-409-4566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POINEAU",
        "first_name": "SYDNEY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "680110579",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYDNEY",
            "last_name": "WENDELS",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.