Provider Demographics
NPI:1194530972
Name:SILVA, JUAN (LPC, NCC)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S WATERS EDGE DR APT F
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-1524
Mailing Address - Country:US
Mailing Address - Phone:708-510-7244
Mailing Address - Fax:
Practice Address - Street 1:2100 MANCHESTER RD STE 1628
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4788
Practice Address - Country:US
Practice Address - Phone:708-510-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178021271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health