Provider Demographics
NPI:1194372540
Name:SILVER, VIRGINIA MARY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:MARY
Last Name:SILVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:VIRGINIA
Other - Middle Name:MARY
Other - Last Name:BRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:349 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-6112
Mailing Address - Country:US
Mailing Address - Phone:516-401-5534
Mailing Address - Fax:631-385-5956
Practice Address - Street 1:349 MILLER AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-6112
Practice Address - Country:US
Practice Address - Phone:516-401-5534
Practice Address - Fax:631-385-5956
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0391941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty