Provider Demographics
NPI:1700141108
Name:SILVA, MARY (MSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SILVA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 231
Mailing Address - Street 2:
Mailing Address - City:FORESTDALE
Mailing Address - State:RI
Mailing Address - Zip Code:02824-0231
Mailing Address - Country:US
Mailing Address - Phone:401-640-2178
Mailing Address - Fax:
Practice Address - Street 1:1 PREMISY HILL RD
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-9592
Practice Address - Country:US
Practice Address - Phone:401-640-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI008601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical