Provider Demographics
NPI:1083104830
Name:GLENDE, SYDNEY RYAN (LPCC)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:RYAN
Last Name:GLENDE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:RYAN
Other - Last Name:COTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:1330 23RD ST ST
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103
Mailing Address - Country:US
Mailing Address - Phone:701-526-4898
Mailing Address - Fax:701-205-4734
Practice Address - Street 1:1330 23RD ST ST
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103
Practice Address - Country:US
Practice Address - Phone:701-526-4898
Practice Address - Fax:701-205-4734
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4778101YP2500X
ND974-9-1-18-407101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional