Provider Demographics
NPI:1134282684
Name:DESILVA, ELAINE BARBARA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:BARBARA
Last Name:DESILVA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BUTTONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248
Mailing Address - Country:US
Mailing Address - Phone:860-228-3412
Mailing Address - Fax:860-228-0669
Practice Address - Street 1:87 BROADWAY
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415
Practice Address - Country:US
Practice Address - Phone:860-537-5280
Practice Address - Fax:860-228-0669
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000822106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist