Provider Demographics
NPI:1942982764
Name:SYDNEE R. CORRIDERS LCSW, PLLC
Entity Type:Organization
Organization Name:SYDNEE R. CORRIDERS LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CORRIDERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-395-1103
Mailing Address - Street 1:118 JACLYN DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-3263
Mailing Address - Country:US
Mailing Address - Phone:347-395-1103
Mailing Address - Fax:
Practice Address - Street 1:118 JACLYN DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205-3263
Practice Address - Country:US
Practice Address - Phone:347-395-1103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty