Provider Demographics
NPI:1922364744
Name:SILVA-GIRALDO, SANDRA M (LCSW)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:SILVA-GIRALDO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12323 SW ARABELLA DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-7728
Mailing Address - Country:US
Mailing Address - Phone:772-626-6827
Mailing Address - Fax:772-220-3484
Practice Address - Street 1:12323 SW ARABELLA DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-7728
Practice Address - Country:US
Practice Address - Phone:772-626-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL222Q00000X, 104100000X
FL157451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1922364744Medicaid
FLPENDINGMedicaid