Provider Demographics
NPI:1629126743
Name:SILVA, MARLENE DRUMMOND (LCPC-C, LADC)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:DRUMMOND
Last Name:SILVA
Suffix:
Gender:F
Credentials:LCPC-C, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 LONE PINE LN
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6119
Mailing Address - Country:US
Mailing Address - Phone:207-712-5469
Mailing Address - Fax:
Practice Address - Street 1:525 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-5462
Practice Address - Country:US
Practice Address - Phone:207-842-2998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME323360101YA0400X
MEME242252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional