Provider Demographics
NPI:1023107042
Name:SILVA, MARISA ANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARISA
Middle Name:ANNE
Last Name:SILVA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 FIRESTONE DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731
Mailing Address - Country:US
Mailing Address - Phone:732-948-3297
Mailing Address - Fax:
Practice Address - Street 1:117 RTE 35
Practice Address - Street 2:SUITE #5
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735-1406
Practice Address - Country:US
Practice Address - Phone:732-948-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00155400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health