Provider Demographics
NPI:1851363774
Name:SILVERHARDT, EDWARD GENE (LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:GENE
Last Name:SILVERHARDT
Suffix:
Gender:M
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12965
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89510-2965
Mailing Address - Country:US
Mailing Address - Phone:775-250-4359
Mailing Address - Fax:775-322-9713
Practice Address - Street 1:2470 WRONDEL WAY
Practice Address - Street 2:SUITE 111
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3701
Practice Address - Country:US
Practice Address - Phone:775-250-4359
Practice Address - Fax:775-322-9713
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4756-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00114504OtherRAILROAD
KSP00114504OtherRAILROAD