Provider Demographics
NPI:1548954944
Name:RENNER, SYDNEY (LISW-S)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:RENNER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:LEVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 ARLINGTON AVE # MS 1180
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2595
Mailing Address - Country:US
Mailing Address - Phone:419-383-4380
Mailing Address - Fax:419-383-2915
Practice Address - Street 1:3125 TRANSVERSE DRIVE
Practice Address - Street 2:RUPPERT HEALTH CENTER
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614
Practice Address - Country:US
Practice Address - Phone:419-383-4380
Practice Address - Fax:419-383-2915
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2102657-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical