Healthcare Provider Details

I. General information

NPI: 1083943690
Provider Name (Legal Business Name): KELVIN SILVER & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2009
Last Update Date: 12/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N CHARLES ST STE 350R
BALTIMORE MD
21201-5318
US

IV. Provider business mailing address

4007 CARLISLE AVE
BALTIMORE MD
21216-1631
US

V. Phone/Fax

Practice location:
  • Phone: 410-952-4088
  • Fax:
Mailing address:
  • Phone: 443-708-5875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCA196
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00043777
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC2343
License Number StateMD

VIII. Authorized Official

Name: KELVIN M SILVER
Title or Position: PRESIDENT & CEO
Credential: LCPC,LCADC,CRC,NCC
Phone: 410-952-4088