Provider Demographics
NPI:1033727086
Name:LEANNA LEE-SYDNOR, LCSW PSYCHOTHERAPY SERVICES,LLC
Entity Type:Organization
Organization Name:LEANNA LEE-SYDNOR, LCSW PSYCHOTHERAPY SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE-SYDNOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CASAC-2
Authorized Official - Phone:914-361-5993
Mailing Address - Street 1:100 RIVERDALE AVE APT 12K
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4618
Mailing Address - Country:US
Mailing Address - Phone:914-361-5993
Mailing Address - Fax:
Practice Address - Street 1:100 RIVERDALE AVE APT 12K
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4618
Practice Address - Country:US
Practice Address - Phone:914-320-6450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02449154Medicaid