Provider Demographics
NPI:1225813439
Name:SYRING, RICHARD C (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:SYRING
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 BRIDLECREST LN
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5851
Mailing Address - Country:US
Mailing Address - Phone:989-941-8656
Mailing Address - Fax:
Practice Address - Street 1:5801 21ST AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5641
Practice Address - Country:US
Practice Address - Phone:941-778-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22754101YM0800X
MA6401008731101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional