Provider Demographics
NPI:1699799643
Name:SILVERMAN, ELLIOTT B (LICSW)
Entity type:Individual
Prefix:MR
First Name:ELLIOTT
Middle Name:B
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4910
Mailing Address - Country:US
Mailing Address - Phone:781-938-5954
Mailing Address - Fax:781-938-7152
Practice Address - Street 1:9 FOREST ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4910
Practice Address - Country:US
Practice Address - Phone:781-431-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1008311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0014267OtherNEIGHBORHOOD HEALTH PLAN
MAPO1502OtherBLUE CROSS
MA669500OtherTUFTS HEALTH PLAN
MAP01502Medicare ID - Type Unspecified