Provider Demographics
NPI:1447383153
Name:SILVER, TINA MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:SILVER
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:BOX 328 CONNECTIONS COUNSELING AND WELLNESS CENTER LLC
Mailing Address - Street 2:163 BOSTON POST RD SUITES 3 & 4
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385
Mailing Address - Country:US
Mailing Address - Phone:860-444-8774
Mailing Address - Fax:860-444-8776
Practice Address - Street 1:163 BOSTON POST RD
Practice Address - Street 2:SUITES 3 & 4 CONNECTIONS COUNSELING AND WELLNESS CENTE
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385
Practice Address - Country:US
Practice Address - Phone:860-444-8774
Practice Address - Fax:860-444-8776
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0054341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004264397Medicaid
CT140005434CT01OtherBCBS