Individual
MRS. MELISSA DISILVESTRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12112
SC
1041C0700X
Clinical Social Worker
P004100
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q53148A
MEDICARE
NC
Enumeration date
03/29/2010
Last updated
10/24/2022
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