Provider Demographics
NPI:1982767182
Name:SILK, LEONARD L (PSYD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:L
Last Name:SILK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 LANGHORNE NEWTOWN ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-504-8118
Mailing Address - Fax:215-504-8259
Practice Address - Street 1:1703 LANGHORNE NEWTOWN ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-504-8118
Practice Address - Fax:215-504-8259
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007386L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0713014000OtherPERSONAL CHOICE
4491502OtherAETNA HMO
PA001643041Medicaid
000769040OtherHIGHMARK