| Doctor Name: | RUSSELL BRADLEY SILVERBERG |
| NPI Number: | 1043594864 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.A.C. |
| License Number: | LAC-13137 |
| Business Practice Address: | 140 North Litchfield Road Suite 200 Goodyear, AZ - 853381226 |
| Business Phone Number: | 6022437277 |
| Business Fax Number: | 6023238048 |
| Mailing Address: | 2702 North 3rd Street, Suite 4020 PHOENIX |
| State: | AZ |
| Postal Code: | 850044608 |
| Phone Number: | 6023233344 |
| Fax Number: | 6023233496 |
| NPI Enumeration Date: | 09/29/2011 |
| NPI Last Update Date: | 01/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LAC-13137 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |