Provider Demographics
NPI:1033095344
Name:SILVA, ELLEN ELISABETH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:ELISABETH
Last Name:SILVA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 BALLAHACK RD
Mailing Address - Street 2:
Mailing Address - City:HERTFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27944-8351
Mailing Address - Country:US
Mailing Address - Phone:252-339-1814
Mailing Address - Fax:
Practice Address - Street 1:150 PIONEER RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23437-9513
Practice Address - Country:US
Practice Address - Phone:757-925-5782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202011803235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist