Provider Demographics
NPI:1326446881
Name:ABRAMS-SILVA, LYNETTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LYNETTE
Middle Name:
Last Name:ABRAMS-SILVA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CENTRAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2805
Mailing Address - Country:US
Mailing Address - Phone:505-243-0335
Mailing Address - Fax:505-216-2623
Practice Address - Street 1:1300 CENTRAL AVE SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2805
Practice Address - Country:US
Practice Address - Phone:505-243-0335
Practice Address - Fax:505-216-2623
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPSY1461103G00000X
IL071008750103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM21971871Medicaid