Provider Demographics
NPI:1598040313
Name:SILVIA, CHRISTINA JANINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JANINE
Last Name:SILVIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:JANINE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:519 HERITAGE ROAD
Mailing Address - Street 2:SUITE 1H
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-1409
Mailing Address - Country:US
Mailing Address - Phone:203-994-9993
Mailing Address - Fax:
Practice Address - Street 1:519 HERITAGE ROAD
Practice Address - Street 2:SUITE 1H
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-1409
Practice Address - Country:US
Practice Address - Phone:203-994-9993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT0095201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008003522Medicaid