Provider Demographics
NPI:1043532633
Name:SILVA, PATRICIA YERENA (LBSW,MSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:YERENA
Last Name:SILVA
Suffix:
Gender:F
Credentials:LBSW,MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 MISTY MEADOWS DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-0551
Mailing Address - Country:US
Mailing Address - Phone:505-907-8053
Mailing Address - Fax:
Practice Address - Street 1:4312 CARLISLE BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4811
Practice Address - Country:US
Practice Address - Phone:505-323-3785
Practice Address - Fax:505-323-3850
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52886101YM0800X
NMB-07357104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health