Provider Demographics
NPI:1952504748
Name:SILVA, SHANDRAI OAKLEY (MED, LPC)
Entity Type:Individual
Prefix:
First Name:SHANDRAI
Middle Name:OAKLEY
Last Name:SILVA
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10233 ILLORIA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4823
Mailing Address - Country:US
Mailing Address - Phone:704-504-9578
Mailing Address - Fax:
Practice Address - Street 1:601 S CLAY ST
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-3942
Practice Address - Country:US
Practice Address - Phone:704-866-6297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4540101YP2500X
NC101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool