Provider Demographics
NPI:1225256878
Name:SIBBLIES-SYMES, LAURI (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURI
Middle Name:
Last Name:SIBBLIES-SYMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 HUNGRY HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3637
Mailing Address - Country:US
Mailing Address - Phone:718-334-1921
Mailing Address - Fax:718-334-3432
Practice Address - Street 1:82-68 164TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-883-3225
Practice Address - Fax:718-883-6193
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0527931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY0033S231Medicare ID - Type Unspecified