Healthcare Provider Details

I. General information

NPI: 1346333044
Provider Name (Legal Business Name): DIANE ELIZABETH SILMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 04/16/2020
Certification Date: 04/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 WASHINGTON ST # 100
DONIPHAN MO
63935-1649
US

IV. Provider business mailing address

1188 RIPLEY 142E-24
DONIPHAN MO
63935-9832
US

V. Phone/Fax

Practice location:
  • Phone: 573-429-3933
  • Fax: 573-351-1243
Mailing address:
  • Phone: 573-429-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2003016981
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: