Provider Demographics
NPI:1679805667
Name:SILVA, LYNDA RAE (LPC)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:RAE
Last Name:SILVA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4076 RIVERMIST LN
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4952
Mailing Address - Country:US
Mailing Address - Phone:801-341-4136
Mailing Address - Fax:
Practice Address - Street 1:11075 S STATE ST
Practice Address - Street 2:SUITE 28
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-5164
Practice Address - Country:US
Practice Address - Phone:801-501-8444
Practice Address - Fax:801-501-7317
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3314396004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health