Provider Demographics
NPI:1972283497
Name:DARTON-RITCHIE, SYDNEY (LSW)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:DARTON-RITCHIE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:DARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12206 CLIFTON BLVD APT 25
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-2191
Mailing Address - Country:US
Mailing Address - Phone:216-609-6456
Mailing Address - Fax:
Practice Address - Street 1:2121 W 117TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-1642
Practice Address - Country:US
Practice Address - Phone:216-609-6456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS2411074104100000X
OHCDCA.183853101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0027384Medicaid