Provider Demographics
NPI:1841311206
Name:SILBERMANN, SANDRA LEE (LCSW-C)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE
Last Name:SILBERMANN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 FIDLER LN
Mailing Address - Street 2:1218
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3425
Mailing Address - Country:US
Mailing Address - Phone:301-588-6515
Mailing Address - Fax:
Practice Address - Street 1:1110 FIDLER LN
Practice Address - Street 2:1218
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3425
Practice Address - Country:US
Practice Address - Phone:301-588-6515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD039811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408062900Medicaid
MDQG09OtherMAGELLAN PV#40
MD03981OtherMD LCSW-C
MD52196OtherINFOR MED ENVOY
MD47-0899-197OtherFED TAX ID
MD408062900Medicaid