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NPI Code Detail

MEDICARE: BETTY JEAN OLIVER MSW, LCSW

MEDICARE: BETTY JEAN OLIVER MSW, 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 WorkerCSW001926GA

General Provider Information

NPI Number : 1972374692
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETTY JEAN OLIVER MSW, LCSW
Provider Business Mailing Address
First Line : 9140 MIDLAND WOODS DR
Second Line :
City : MIDLAND
State : GA
Zip : 31820-4203
Country : US
Telephone Number : 706-992-9454
Fax Number :
Provider Business Practice Location Address
First Line : 2301 BROOKSTONE CENTRE PKWY STE 200
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-9219
Country : US
Telephone Number : 706-940-5677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2024
Last Update Date : 08/27/2024

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