Healthcare Provider Details

I. General information

NPI: 1780949180
Provider Name (Legal Business Name): COBI ANNIE SILVER HEWITT DBH, MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COBI ANNIE SILVER DBH, MSW, LCSW

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 MAIN ST
AUMSVILLE OR
97325
US

IV. Provider business mailing address

1401 N 10TH AVE
STAYTON OR
97383
US

V. Phone/Fax

Practice location:
  • Phone: 503-749-4734
  • Fax: 503-769-5877
Mailing address:
  • Phone: 503-769-2175
  • Fax: 503-769-5877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC60486895
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7974
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: