MEDICARE: MARY SILVESTROS LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW018717	PA

General Provider Information

NPI Number	:	1164812525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY SILVESTROS LSW

Provider Business Mailing Address
First Line	:	2400 ANSYS DR STE 102
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-0403
Country	:	US
Telephone Number	:	724-209-4970
Fax Number	:	724-307-4135

Provider Business Practice Location Address
First Line	:	135 TECHNOLOGY DR STE 312
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-9549
Country	:	US
Telephone Number	:	724-209-4970
Fax Number	:	724-307-4135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2015
Last Update Date	:	01/26/2024

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