Provider Demographics
NPI:1346302528
Name:BISKIND SILVERMAN, JESSICA BETSY ROSE (LPC, MFT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:BETSY ROSE
Last Name:BISKIND SILVERMAN
Suffix:
Gender:F
Credentials:LPC, MFT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:BETSY ROSE
Other - Last Name:BISKIND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPC
Mailing Address - Street 1:124 HOWARD STREET
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952
Mailing Address - Country:US
Mailing Address - Phone:707-772-9671
Mailing Address - Fax:
Practice Address - Street 1:124 HOWARD STREET
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952
Practice Address - Country:US
Practice Address - Phone:707-772-9671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OR2412101YP2500X
CA79864106H00000X
ORC2412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist