Provider Demographics
NPI:1700068905
Name:SUGARMAN, SIDNEY INGRID (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SIDNEY
Middle Name:INGRID
Last Name:SUGARMAN
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 1:107 W 86TH ST
Mailing Address - Street 2:8B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3409
Mailing Address - Country:US
Mailing Address - Phone:212-787-0788
Mailing Address - Fax:
Practice Address - Street 1:107 W 86TH ST
Practice Address - Street 2:8B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3409
Practice Address - Country:US
Practice Address - Phone:212-787-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR015979-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical