Provider Demographics
NPI:1295874121
Name:CHARISON, SILVANA CRISTINA (LPC)
Entity type:Individual
Prefix:MS
First Name:SILVANA
Middle Name:CRISTINA
Last Name:CHARISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SILVANA
Other - Middle Name:CRISTINA
Other - Last Name:BEILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 MACARTHUR BLVD. SUITE 600
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:949-424-3084
Mailing Address - Fax:
Practice Address - Street 1:4000 MACARTHUR BLVD. SUITE 600
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-424-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
VA0701004134101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1295874121Medicaid
VA4945247Medicaid