Healthcare Provider Details
I. General information
NPI: 1508282393
Provider Name (Legal Business Name): STUART E. SILBERMAN, PSY.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2014
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
132 E BROADWAY SUITE 730
EUGENE OR
97401-3143
US
IV. Provider business mailing address
132 E BROADWAY SUITE 730
EUGENE OR
97401-3143
US
V. Phone/Fax
- Phone: 541-632-4655
- Fax: 541-214-2639
- Phone: 541-632-4655
- Fax: 541-214-2639
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | 2363 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | 2363 |
| License Number State | OR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
STUART
EUGENE
SILBERMAN
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 541-632-4655