MEDICARE: CAITLIN SILVERSTEIN LCSW

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
1	104100000X	Social Worker	100943	NY

General Provider Information

NPI Number	:	1417578758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN SILVERSTEIN LCSW

Provider Business Mailing Address
First Line	:	500 PORTION RD STE 12
Second Line	:
City	:	LAKE RONKONKOMA
State	:	NY
Zip	:	11779-4587
Country	:	US
Telephone Number	:	631-380-4999
Fax Number	:	631-381-6072

Provider Business Practice Location Address
First Line	:	500 PORTION RD STE 12
Second Line	:
City	:	LAKE RONKONKOMA
State	:	NY
Zip	:	11779-4587
Country	:	US
Telephone Number	:	631-380-4999
Fax Number	:	631-381-6072

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2020
Last Update Date	:	06/13/2024

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