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General NPI Number Information
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NPI Number | 1417453846
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Entity Type | Individual
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Provider Name | SUSAN SILVER L.S.W.
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Gender | Female
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 04/04/2018
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Provider Practice Location Address
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Address Line | 122 W HILL ST
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City | CHAMPAIGN
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State | IL
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Zip | 61820-3519
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Country | US
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Telephone | 217-356-7576
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 S RACE ST
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City | URBANA
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State | IL
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Zip | 61801-4956
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Country | US
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Telephone | 217-898-8895
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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 | 150-002075
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License Number State | IL
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