National Provider Identifier

Laura Jeanne Syvertson, LCSW

Laura Jeanne Syvertson, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Ithaca, NY and a listed phone number of (607) 220-7319.

NPI 1295088979Ithaca, NYClinical Social Worker

Profile Overview

NPI
1295088979
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
October 18, 2012
Last Updated
October 03, 2025

Practice Location

  • 319 N Tioga
  • Ithaca, NY 14850

Phone: (607) 220-7319

Mailing Address

  • 409 Elm St
  • Ithaca, NY 14850

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1295088979
Entity Type
Individual
Last Name
Syvertson
First Name
Laura
Middle Name
Jeanne
Credential
LCSW
Mailing Street Address
409 Elm St
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850
Mailing Country
US
Practice Street Address
319 N Tioga
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850
Practice Country
US
Practice Phone
(607) 220-7319
Enumeration Date
October 18, 2012
Last Updated
October 03, 2025
Sex
Female
Sole Proprietor
No
Certification Date
October 03, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)