Provider Demographics
NPI:1992876841
Name:SILVERTHORN, BRIAN T (LCSW)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:T
Last Name:SILVERTHORN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NASHVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-2948
Mailing Address - Country:US
Mailing Address - Phone:931-359-5802
Mailing Address - Fax:931-359-0148
Practice Address - Street 1:1601 NASHVILLE HWY
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-2948
Practice Address - Country:US
Practice Address - Phone:931-359-5802
Practice Address - Fax:931-359-0148
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000040701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN364365422OtherTAX ID