Healthcare Provider Details

I. General information

NPI: 1427827021
Provider Name (Legal Business Name): SILVIA PORTILLO BROOKS LPC, LSATP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CHESTER ST STE E
FRONT ROYAL VA
22630-3308
US

IV. Provider business mailing address

315 CABLE PL
FRONT ROYAL VA
22630-3019
US

V. Phone/Fax

Practice location:
  • Phone: 240-643-8756
  • Fax: 888-527-6181
Mailing address:
  • Phone: 240-643-8756
  • Fax: 888-527-6181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0718000793
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701013095
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: