Provider Demographics
NPI:1750029179
Name:CHRISTINA J SILVIA LCSW LLC
Entity Type:Organization
Organization Name:CHRISTINA J SILVIA LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SILVIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-994-9993
Mailing Address - Street 1:1031 OLD WATERBURY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-1921
Mailing Address - Country:US
Mailing Address - Phone:203-994-9993
Mailing Address - Fax:
Practice Address - Street 1:519 HERITAGE RD STE 1H
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-1699
Practice Address - Country:US
Practice Address - Phone:203-994-9993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1598040313Medicaid