Provider Demographics
NPI:1245475920
Name:LINDA M. SILVA, LLC
Entity type:Organization
Organization Name:LINDA M. SILVA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-745-0274
Mailing Address - Street 1:460 W MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-7127
Mailing Address - Country:US
Mailing Address - Phone:706-633-8145
Mailing Address - Fax:706-946-6574
Practice Address - Street 1:460 W MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-7127
Practice Address - Country:US
Practice Address - Phone:706-633-8145
Practice Address - Fax:706-946-6574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005261101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA100124010Medicaid
GA600078-637OtherMAGELLAN
GA9740178OtherAETNA