Provider Demographics
NPI:1730541467
Name:SILVA, KAREN MAE (LCPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MAE
Last Name:SILVA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-4447
Mailing Address - Country:US
Mailing Address - Phone:208-816-3307
Mailing Address - Fax:
Practice Address - Street 1:424 WARNER AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-4447
Practice Address - Country:US
Practice Address - Phone:208-816-3307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC 3525101YP2500X
IDLCPC-6979101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDLCPC6979OtherSTATE OF IDAHO LICENSING BUREAU
IDLPC 3525OtherLICENSED PROFESSIONAL COUNSELOR