Basic Information
Provider Information
NPI: 1992377857
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: APPLEWHITE
FirstName: SYDNEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BCBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7500 SAN FELIPE ST STE 990
Address2:  
City: HOUSTON
State: TX
PostalCode: 770631708
CountryCode: US
TelephoneNumber: 2818263382
FaxNumber:  
Practice Location
Address1: 4170 N 108TH AVE
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850375469
CountryCode: US
TelephoneNumber: 4807511957
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/12/2021
LastUpdateDate: 07/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X  Y Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


Home