Provider Demographics
NPI:1023314903
Name:ARDIS, SYLVIA M (MFT)
Entity type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:M
Last Name:ARDIS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1896 JUDWICK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5306
Mailing Address - Country:US
Mailing Address - Phone:614-785-1989
Mailing Address - Fax:
Practice Address - Street 1:4488 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-5610
Practice Address - Country:US
Practice Address - Phone:614-877-0667
Practice Address - Fax:614-870-6855
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM1000011106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist