Provider Demographics
NPI:1174994750
Name:SILVAINE, SAM PRANGER (LPC)
Entity type:Individual
Prefix:
First Name:SAM
Middle Name:PRANGER
Last Name:SILVAINE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:MARIE EVANOFF
Other - Last Name:PRANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1236 PRESTON GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8469
Mailing Address - Country:US
Mailing Address - Phone:630-485-0391
Mailing Address - Fax:
Practice Address - Street 1:120 PROVIDENCE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:630-485-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2021-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional