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NPI Code Detail

MEDICARE: OLIVIA MICHELLE RORAGEN LCSW

MEDICARE: OLIVIA MICHELLE RORAGEN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW-23810AZ

General Provider Information

NPI Number : 1790615854
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA MICHELLE RORAGEN LCSW
Provider Business Mailing Address
First Line : 3001 N 33RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-5202
Country : US
Telephone Number : 602-353-0703
Fax Number : 602-353-0715
Provider Business Practice Location Address
First Line : 3001 N 33RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-5202
Country : US
Telephone Number : 602-353-0703
Fax Number : 602-353-0715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ OLIVIA MICHELLE RORAGEN LCSW” Practice Location

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