Provider Demographics
NPI:1760526875
Name:ORTIZ, SYLVIA TERESA (LCSW)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:TERESA
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:ORTIZ RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:26 COURT ST
Mailing Address - Street 2:SUITE 602
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-0103
Mailing Address - Country:US
Mailing Address - Phone:917-921-3103
Mailing Address - Fax:718-434-5181
Practice Address - Street 1:26 COURT ST
Practice Address - Street 2:SUITE 602
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-0103
Practice Address - Country:US
Practice Address - Phone:917-921-3103
Practice Address - Fax:718-434-5181
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0698561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02148281Medicaid
NYNH3361Medicare ID - Type Unspecified