Provider Demographics
NPI:1043594864
Name:SILVERBERG, RUSSELL (DBH, NCC, LPC, LMHC)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:
Last Name:SILVERBERG
Suffix:
Gender:M
Credentials:DBH, NCC, LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 E CACTUS RD # 505-855
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4163
Mailing Address - Country:US
Mailing Address - Phone:855-270-1100
Mailing Address - Fax:
Practice Address - Street 1:4848 E CACTUS RD # 505-855
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4163
Practice Address - Country:US
Practice Address - Phone:855-270-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH-60312837101YM0800X
AZLPC-15969101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health