Healthcare Provider Details

I. General information

NPI: 1629035381
Provider Name (Legal Business Name): SILVIA NATASHA BALSARA PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 ROGERS AVE SUITE 510
FORT SMITH AR
72903-2047
US

IV. Provider business mailing address

5111 ROGERS AVE SUITE 510
FORT SMITH AR
72903-2047
US

V. Phone/Fax

Practice location:
  • Phone: 479-462-3828
  • Fax: 240-352-8326
Mailing address:
  • Phone: 479-462-3828
  • Fax: 240-352-8326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP9310028
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM9710005
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: