Provider Demographics
NPI:1174960462
Name:DA SILVA, MARIA (LPC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:DA SILVA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18800 EGRET BAY BLVD
Mailing Address - Street 2:SUITE 1613
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3834
Mailing Address - Country:US
Mailing Address - Phone:713-366-6988
Mailing Address - Fax:
Practice Address - Street 1:2600 S SHORE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2943
Practice Address - Country:US
Practice Address - Phone:713-366-6988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68150101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional