Healthcare Provider Details

I. General information

NPI: 1043532633
Provider Name (Legal Business Name): PATRICIA YERENA SILVA LBSW,MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2010
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4312 CARLISLE BLVD NE
ALBUQUERQUE NM
87107-4811
US

IV. Provider business mailing address

3421 MISTY MEADOWS DR NE
RIO RANCHO NM
87144-0551
US

V. Phone/Fax

Practice location:
  • Phone: 505-323-3785
  • Fax: 505-323-3850
Mailing address:
  • Phone: 505-907-8053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number52886
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberB-07357
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: