Provider Demographics
NPI:1336398817
Name:DASILVA, NICOLE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:DASILVA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 SHAW ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-5346
Mailing Address - Country:US
Mailing Address - Phone:508-965-9129
Mailing Address - Fax:844-266-5677
Practice Address - Street 1:279 SHAW ST APT 2
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-5346
Practice Address - Country:US
Practice Address - Phone:508-965-9129
Practice Address - Fax:844-266-5677
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2152001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical