Provider Demographics
NPI:1558678128
Name:SILVERIA, LISA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:SILVERIA
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 1:31 FAIRMOUNT ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-4812
Mailing Address - Country:US
Mailing Address - Phone:781-620-0880
Mailing Address - Fax:
Practice Address - Street 1:31 FAIRMOUNT ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-4812
Practice Address - Country:US
Practice Address - Phone:781-620-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health