Provider Demographics
NPI:1609610955
Name:BURROW, SYDNE GRACE (LCMHC-A, CRC)
Entity type:Individual
Prefix:
First Name:SYDNE
Middle Name:GRACE
Last Name:BURROW
Suffix:
Gender:F
Credentials:LCMHC-A, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 S CROATAN HIGHWAY
Mailing Address - Street 2:D7 PMB 21
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959
Mailing Address - Country:US
Mailing Address - Phone:252-255-2733
Mailing Address - Fax:
Practice Address - Street 1:2224 S CROATAN HIGHWAY
Practice Address - Street 2:D7 PMB 21
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959
Practice Address - Country:US
Practice Address - Phone:252-255-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health