Provider Demographics
NPI:1700274248
Name:SILVA, ANGELA JOY (MA, LPCC-S)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:JOY
Last Name:SILVA
Suffix:
Gender:F
Credentials:MA, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456-0072
Mailing Address - Country:US
Mailing Address - Phone:606-401-2075
Mailing Address - Fax:606-401-2076
Practice Address - Street 1:20 LOVELL COURT
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:KY
Practice Address - Zip Code:40456
Practice Address - Country:US
Practice Address - Phone:606-401-2075
Practice Address - Fax:606-401-2076
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175225101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100498980Medicaid