Provider Demographics
NPI:1548665987
Name:SILVERMAN, ELISSA BETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELISSA
Middle Name:BETH
Last Name:SILVERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ELISSA
Other - Middle Name:BETH
Other - Last Name:LUBARSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4302 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-3953
Mailing Address - Country:US
Mailing Address - Phone:602-791-3248
Mailing Address - Fax:
Practice Address - Street 1:1130 E MISSOURI AVE STE 780
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2730
Practice Address - Country:US
Practice Address - Phone:602-777-6156
Practice Address - Fax:602-513-7303
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-152441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ960744Medicaid
AZZ172298Medicare PIN