Provider Demographics
NPI:1568737880
Name:SILVERHARDT, JACQUELINE QUEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:QUEEN
Last Name:SILVERHARDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:JACQUELINE
Other - Middle Name:QUEEN
Other - Last Name:CURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 ACADEMY CIR
Mailing Address - Street 2:UNIT 308
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-5239
Mailing Address - Country:US
Mailing Address - Phone:843-697-0398
Mailing Address - Fax:
Practice Address - Street 1:1903 S. BROAD ST.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2328
Practice Address - Country:US
Practice Address - Phone:215-339-4563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0171691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical