| Persephanie Silverthorn Phd Licensed Clinical Psychologist Llc | |
|
887 Hailey Ave Slidell LA 70458-4437 | |
| (985) 661-8400 | |
| (985) 643-7454 |
| Full Name | Persephanie Silverthorn Phd Licensed Clinical Psychologist Llc |
|---|---|
| Speciality | Psychologist |
| Location | 887 Hailey Ave, Slidell, Louisiana |
| Authorized Official Name and Position | Persephanie Silverthorn (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9856618400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Persephanie Silverthorn Phd Licensed Clinical Psychologist Llc 887 Hailey Ave Slidell LA 70458-4437 Ph: (985) 661-8400 | Persephanie Silverthorn Phd Licensed Clinical Psychologist Llc 887 Hailey Ave Slidell LA 70458-4437 Ph: (985) 661-8400 |
| NPI Number | 1720319775 |
|---|---|
| Provider Enumeration Date | 01/14/2010 |
| Last Update Date | 01/14/2010 |
| Medicare PECOS PAC ID | 2567606551 |
|---|---|
| Medicare Enrollment ID | O20130912000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720319775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 868 (Louisiana) | Primary |
| Provider Name | Persephanie Silverthorn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982764072 PECOS PAC ID: 4284878281 Enrollment ID: I20130912000574 |
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