Provider Demographics
NPI:1457143323
Name:HOUSTON, SYDNEY M (LCSW)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:M
Last Name:HOUSTON
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 1:819 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1066
Mailing Address - Country:US
Mailing Address - Phone:732-455-2628
Mailing Address - Fax:
Practice Address - Street 1:819 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-1066
Practice Address - Country:US
Practice Address - Phone:732-996-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL067018001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical