Provider Demographics
NPI:1801164397
Name:SILVESTRO, AMY KATE (LCSW- R)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:KATE
Last Name:SILVESTRO
Suffix:
Gender:F
Credentials:LCSW- R
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 1176
Mailing Address - Street 2:
Mailing Address - City:PORT EWEN
Mailing Address - State:NY
Mailing Address - Zip Code:12466-1176
Mailing Address - Country:US
Mailing Address - Phone:845-399-8707
Mailing Address - Fax:
Practice Address - Street 1:319 BROADWAY
Practice Address - Street 2:
Practice Address - City:PORT EWEN
Practice Address - State:NY
Practice Address - Zip Code:12466-5501
Practice Address - Country:US
Practice Address - Phone:845-399-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-037349-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical