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General NPI Number Information
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NPI Number | 1629457874
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Entity Type | Organization
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Legal Business Name | HOLLIS SILVERMAN, PA
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 621 NW 53RD ST STE 125
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City | BOCA RATON
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State | FL
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Zip | 33487-8236
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Country | US
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Telephone | 954-663-2475
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Fax |
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Provider Business Mailing Address
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Address Line | 111 EUBANKS CT
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City | WOODSTOCK
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State | GA
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Zip | 30188-1903
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Country | US
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Telephone | 954-663-2475
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | HOLLIS WIDDEKIND
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Credential | LCSW, CST
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Telephone | 954-663-2475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW 12779
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License Number State | FL
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