Provider Demographics
NPI:1770218661
Name:MARMON, SYDNEY (LMHC)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:MARMON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10383
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-0383
Mailing Address - Country:US
Mailing Address - Phone:701-578-4618
Mailing Address - Fax:
Practice Address - Street 1:2503 DEL PRADO BLVD S STE 410A
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5709
Practice Address - Country:US
Practice Address - Phone:239-443-6385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-23
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20942101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health