Provider Demographics
NPI:1538922232
Name:ENTEN, SYDNEY T (LMSW)
Entity type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:T
Last Name:ENTEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 PALMETTO ST APT 2
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-2927
Mailing Address - Country:US
Mailing Address - Phone:864-884-1681
Mailing Address - Fax:
Practice Address - Street 1:1875 PALMETTO ST APT 2
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-2927
Practice Address - Country:US
Practice Address - Phone:864-884-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114921104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker