Provider Demographics
NPI:1609984939
Name:MADRID, SILVIA (MA LPCC LADAC)
Entity Type:Individual
Prefix:MS
First Name:SILVIA
Middle Name:
Last Name:MADRID
Suffix:
Gender:F
Credentials:MA LPCC LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1349
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-1349
Mailing Address - Country:US
Mailing Address - Phone:575-388-4497
Mailing Address - Fax:575-534-1150
Practice Address - Street 1:315 S HUDSON
Practice Address - Street 2:SUITE 12
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061
Practice Address - Country:US
Practice Address - Phone:575-388-4497
Practice Address - Fax:575-534-1150
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3538101YA0400X
NM0227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM96123257Medicaid