Provider Demographics
NPI:1679394142
Name:DASILVA, CHRISTIANE (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:
Last Name:DASILVA
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 STOWE RD
Mailing Address - Street 2:
Mailing Address - City:TANNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18372-7886
Mailing Address - Country:US
Mailing Address - Phone:570-350-2505
Mailing Address - Fax:
Practice Address - Street 1:105 TERRACE DR STE 102
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-7510
Practice Address - Country:US
Practice Address - Phone:570-620-4311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017695101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional