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General NPI Number Information
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NPI Number | 1548665987
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Entity Type | Individual
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Provider Name | ELISSA BETH SILVERMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 01/02/2019
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Provider Practice Location Address
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Address Line | 1130 E MISSOURI AVE STE 780
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City | PHOENIX
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State | AZ
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Zip | 85014-2730
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Country | US
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Telephone | 602-777-6156
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Fax | 602-513-7303
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Provider Business Mailing Address
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Address Line | 4302 E BANNOCK ST
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City | PHOENIX
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State | AZ
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Zip | 85044-3953
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Country | US
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Telephone | 602-791-3248
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-15244
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License Number State | AZ
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