Provider Demographics
NPI:1235464041
Name:SILVA, ANISE AUDREY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANISE
Middle Name:AUDREY
Last Name:SILVA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W OGDEN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3179
Mailing Address - Country:US
Mailing Address - Phone:630-986-2066
Mailing Address - Fax:630-986-1477
Practice Address - Street 1:501 W OGDEN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3179
Practice Address - Country:US
Practice Address - Phone:630-986-2066
Practice Address - Fax:630-986-1477
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0130741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical