Provider Demographics
NPI:1336719681
Name:SILOR, SAMANTHA (MHC, MA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SILOR
Suffix:
Gender:F
Credentials:MHC, MA
Other - Prefix:
Other - First Name:SAM
Other - Middle Name:
Other - Last Name:SILOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHC, MA
Mailing Address - Street 1:2519 34TH ST APT 3R
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-4920
Mailing Address - Country:US
Mailing Address - Phone:205-919-3777
Mailing Address - Fax:
Practice Address - Street 1:875 6TH AVE RM 2300
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3507
Practice Address - Country:US
Practice Address - Phone:732-778-0107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP109608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health