Healthcare Provider Details

I. General information

NPI: 1245008556
Provider Name (Legal Business Name): SYDNEY SMYK, LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 01/25/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16529 COASTAL HWY
LEWES DE
19958-3696
US

IV. Provider business mailing address

2 OAKRIDGE DR
MILTON DE
19968-9600
US

V. Phone/Fax

Practice location:
  • Phone: 302-381-1926
  • Fax:
Mailing address:
  • Phone: 302-381-1926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SYDNEY SMYK
Title or Position: OUTPATIENT THERAPIST
Credential: LCSW
Phone: 302-381-1926