Provider Demographics
NPI:1295862993
Name:SILAS, AMY BETH (MS, LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:SILAS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 N 427
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-8337
Mailing Address - Country:US
Mailing Address - Phone:918-864-2899
Mailing Address - Fax:918-825-2234
Practice Address - Street 1:729 N 427
Practice Address - Street 2:
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-8337
Practice Address - Country:US
Practice Address - Phone:918-864-2899
Practice Address - Fax:918-825-2234
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2791101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional