Provider Demographics
NPI:1700356995
Name:BULLINS, SYDNEY CRUTCHFIELD (LPCA)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:CRUTCHFIELD
Last Name:BULLINS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 S FAYETTEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-6831
Mailing Address - Country:US
Mailing Address - Phone:336-465-8476
Mailing Address - Fax:
Practice Address - Street 1:1 CENTERVIEW DR STE 300
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3712
Practice Address - Country:US
Practice Address - Phone:336-617-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14479101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional