Provider Demographics
NPI:1376912261
Name:POLLOCK-TOBERT, SYDNEY LAURA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:LAURA
Last Name:POLLOCK-TOBERT
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 1:295 CENTRAL PARK W OFC 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3021
Mailing Address - Country:US
Mailing Address - Phone:201-417-5597
Mailing Address - Fax:
Practice Address - Street 1:27 W 96TH ST STE AOFFICE2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6607
Practice Address - Country:US
Practice Address - Phone:201-417-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097718104100000X
NY0885471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker