Healthcare Provider Details

I. General information

NPI: 1639617772
Provider Name (Legal Business Name): SILVERLEAF CONSULTING SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 FOREST BAY CT
GAMBRILLS MD
21054-1603
US

IV. Provider business mailing address

929 FOREST BAY CT
GAMBRILLS MD
21054-1603
US

V. Phone/Fax

Practice location:
  • Phone: 410-294-0152
  • Fax:
Mailing address:
  • Phone: 410-294-0152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15992
License Number StateMD

VIII. Authorized Official

Name: HEATHER JOY SILVER
Title or Position: LICENSED CLINICIAN/PERINATAL SPEC.
Credential: LCSW-C, CPLC
Phone: 410-294-0152