Provider Demographics
NPI:1629457874
Name:HOLLIS SILVERMAN, PA
Entity Type:Organization
Organization Name:HOLLIS SILVERMAN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WIDDEKIND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CST
Authorized Official - Phone:954-663-2475
Mailing Address - Street 1:111 EUBANKS CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-1903
Mailing Address - Country:US
Mailing Address - Phone:954-663-2475
Mailing Address - Fax:
Practice Address - Street 1:621 NW 53RD ST STE 125
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-8236
Practice Address - Country:US
Practice Address - Phone:954-663-2475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 12779251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health