Sydni Marmor, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4019 Issued in CT

Practice address

17 S Highland St
West Hartford, CT 06119-1826

Phone

(860) 258-4171

NPI assigned

Mar 4, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Sydni Camillo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Becoming Suryani LLC

  • Mental Health Counselor
  • West Hartford, CT
  • NPI 1801495734
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1235764804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 OPENING HILL RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064438203",
            "telephone_number": "203-521-2439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S HIGHLAND ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191826",
            "telephone_number": "860-258-4171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 Main St Unit 121",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "CT",
            "postal_code": "064682872",
            "country_code": "US",
            "telephone_number": "203-610-9729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARMOR",
        "first_name": "SYDNI",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "4019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYDNI",
            "last_name": "CAMILLO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.