Provider Demographics
NPI:1407214869
Name:SILVESTRI, MEGAN (LMHC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SILVESTRI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15226 AGAVE GROVE PLACE
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-3602
Mailing Address - Country:US
Mailing Address - Phone:407-575-3204
Mailing Address - Fax:
Practice Address - Street 1:15226 AGAVE GROVE PLACE
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-3602
Practice Address - Country:US
Practice Address - Phone:407-575-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC617101YP2500X
FLMH13779101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH13779OtherLICENSE