Healthcare Provider Details

I. General information

NPI: 1811377500
Provider Name (Legal Business Name): KELVIN SILVER & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 06/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 N CHARLES ST SUITE 301
BALTIMORE MD
21218-5760
US

IV. Provider business mailing address

2115 N CHARLES ST SUITE 301
BALTIMORE MD
21218-5760
US

V. Phone/Fax

Practice location:
  • Phone: 410-952-4088
  • Fax:
Mailing address:
  • Phone: 410-952-4088
  • 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 TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC2343
License Number StateMD

VIII. Authorized Official

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