Silver Sage Psychiatry, LLC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

Legal business name

SILVER SAGE PSYCHIATRY, LLC

Practice address

724 Front St Ste 404
Evanston, WY 82930-3589

Phone

(307) 288-2328

NPI assigned

Jan 19, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Marisha Vanvleet, APRN-CNP, PMHNP-BCNPI 1730856147

Title

Ceo

Phone

(307) 288-2329

Specialties & licenses 1

Addresses

Other names 1

• Silver Sage Psychiatry LLC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marisha Lee Vanvleet, APRN-CNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lander, WY
  • NPI 1730856147
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1619629912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 FRONT ST STE 404",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303589",
            "telephone_number": "307-288-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 FRONT ST STE 404",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303589",
            "telephone_number": "307-288-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER SAGE PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "VANVLEET",
        "authorized_official_first_name": "MARISHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-288-2329",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN-CNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "practice email address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "724 Front St Ste 404",
            "city": "Evanston",
            "state": "WY",
            "country_code": "US",
            "postal_code": "829303589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Silver Sage Psychiatry LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candyce Lynn Shields, PH.D
• Chrystanne Lynn Shillcox, R.PH.
• Clair Siebrecht
• Lauren Silberstein, PH.D.
• Kathy Silcox
• Thomas James Simon, M.D.
• Andrea Michelle Smith
• Logan Smith
• Maureen Ann Smith
• Smiths Food & Drug Centers Inc

• Psychiatric/Mental Health Clinical Nurse Specialist in Evanston, WY
• Providers in Evanston, WY by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.