Provider Demographics
NPI:1942501184
Name:SILVA, MATTHEW STEWART (MA, MBA, LPC,)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:STEWART
Last Name:SILVA
Suffix:
Gender:M
Credentials:MA, MBA, LPC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FOXCLIFF CT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4233
Mailing Address - Country:US
Mailing Address - Phone:314-249-6922
Mailing Address - Fax:
Practice Address - Street 1:9890 CLAYTON RD
Practice Address - Street 2:SUITE 127
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-1685
Practice Address - Country:US
Practice Address - Phone:314-249-6922
Practice Address - Fax:314-222-6319
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015014885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional