Provider Demographics
NPI:1487836003
Name:RIDLEN, SYLVIA (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:
Last Name:RIDLEN
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SHERMAN PL
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3730
Mailing Address - Country:US
Mailing Address - Phone:201-798-5725
Mailing Address - Fax:
Practice Address - Street 1:108 SHERMAN PL
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-3730
Practice Address - Country:US
Practice Address - Phone:201-798-5725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046559001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
634493Medicare PIN