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General NPI Number Information
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NPI Number | 1306354386
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Entity Type | Individual
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Provider Name | MARY RHEA SILVA LPC
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Gender | Female
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 04/17/2020
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Provider Practice Location Address
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Address Line | 11260 ROGER BACON DR STE 206
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City | RESTON
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State | VA
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Zip | 20190-5252
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Country | US
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Telephone | 816-547-4453
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Fax |
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Provider Business Mailing Address
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Address Line | 1179 CYPRESS TREE PL
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City | HERNDON
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State | VA
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Zip | 20170-4135
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Country | US
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Telephone | 816-547-4453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2017028079
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701006707
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License Number State | VA
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