Provider Demographics
NPI:1821322330
Name:SILVERNALE, ELIZABETH MARIE (PHD, LMHC,LSATP,CAP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:SILVERNALE
Suffix:
Gender:F
Credentials:PHD, LMHC,LSATP,CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2883 EXECUTIVE PARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3662
Mailing Address - Country:US
Mailing Address - Phone:954-228-0530
Mailing Address - Fax:954-384-1163
Practice Address - Street 1:2883 EXECUTIVE PARK DR STE 102
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3662
Practice Address - Country:US
Practice Address - Phone:954-228-0530
Practice Address - Fax:954-384-1163
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000229103TA0400X
FLMH12271101YM0800X
FLCAP 2752101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)