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NPI Code Detail

MEDICARE: MS. LAURA SILVA M.A.., LICMHC

MEDICARE: MS. LAURA SILVA M.A.., LICMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor1469MA

General Provider Information

NPI Number : 1013073212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAURA SILVA M.A.., LICMHC
Provider Business Mailing Address
First Line : 262 TOM SWAMP RD
Second Line :
City : PETERSHAM
State : MA
Zip : 01366-9615
Country : US
Telephone Number : 978-249-4109
Fax Number : 978-249-0997
Provider Business Practice Location Address
First Line : 52 CEDAR ST
Second Line :
City : WORCESTER
State : MA
Zip : 01609-2134
Country : US
Telephone Number : 508-754-1406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2006
Last Update Date : 07/08/2007

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