Provider Demographics
NPI:1629468590
Name:SILVA, JAIME (LPC, CRC, CADC 1)
Entity Type:Individual
Prefix:MR
First Name:JAIME
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:LPC, CRC, CADC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 WEMBLEY AVE NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-1830
Mailing Address - Country:US
Mailing Address - Phone:503-999-3637
Mailing Address - Fax:
Practice Address - Street 1:2395 WEMBLEY AVE NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-1830
Practice Address - Country:US
Practice Address - Phone:503-999-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3015101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional