Provider Demographics
NPI:1164690608
Name:DASILVA, MELISSA R (LICSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:R
Last Name:DASILVA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RICHMOND SQ STE 333W
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5156
Mailing Address - Country:US
Mailing Address - Phone:401-497-8873
Mailing Address - Fax:877-455-9466
Practice Address - Street 1:1 RICHMOND SQ STE 333W
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5156
Practice Address - Country:US
Practice Address - Phone:401-497-8873
Practice Address - Fax:877-455-9466
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1041C0700X
RIISW020641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty