Provider Demographics
NPI:1235182353
Name:MARTIN, SYLVIE (LCSW, LCDP)
Entity Type:Individual
Prefix:
First Name:SYLVIE
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCSW, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 PARKER CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3309
Practice Address - Country:US
Practice Address - Phone:302-656-0651
Practice Address - Fax:302-654-6432
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECD-0000018101YA0400X
DEQ1-00007111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE655799Medicare ID - Type UnspecifiedCATHOLIC CHAR. GRP.