Provider Demographics
NPI:1194147272
Name:SYDER, ELIZABETH (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:SYDER
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 1:2123 PLUNKETT ST.
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020
Mailing Address - Country:US
Mailing Address - Phone:786-414-6666
Mailing Address - Fax:
Practice Address - Street 1:2123 PLUNKETT ST.
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020
Practice Address - Country:US
Practice Address - Phone:786-414-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW117391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical