Provider Demographics
NPI:1780865105
Name:SILVIA R. VON SACKEN, PLLC
Entity type:Organization
Organization Name:SILVIA R. VON SACKEN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW
Authorized Official - Prefix:MS
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:VON SACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-329-6330
Mailing Address - Street 1:6 MARY E CLARK DR STE 3
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-2288
Mailing Address - Country:US
Mailing Address - Phone:603-329-6330
Mailing Address - Fax:603-329-5197
Practice Address - Street 1:6 MARY E CLARK DR STE 3
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841-2288
Practice Address - Country:US
Practice Address - Phone:603-329-6330
Practice Address - Fax:603-329-5197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077779Medicaid
NHRE657201Medicare PIN