Provider Demographics
NPI:1831736172
Name:SYTNER, ALAN (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:SYTNER
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:ARI
Other - Middle Name:
Other - Last Name:SYTNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, PHD
Mailing Address - Street 1:88 RECTOR CT
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-4221
Mailing Address - Country:US
Mailing Address - Phone:843-452-6382
Mailing Address - Fax:
Practice Address - Street 1:141 AYERS CT
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5160
Practice Address - Country:US
Practice Address - Phone:201-903-2515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06111100104100000X
NY0996451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker