Provider Demographics
NPI:1154771756
Name:SILVER, MAUREEN (LCSW)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:SILVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 VILLAGE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-6273
Mailing Address - Country:US
Mailing Address - Phone:631-553-9136
Mailing Address - Fax:
Practice Address - Street 1:4 VILLAGE PLAZA DR
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6273
Practice Address - Country:US
Practice Address - Phone:631-553-9136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0841111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical