Healthcare Provider Details

I. General information

NPI: 1932765286
Provider Name (Legal Business Name): MYSHEL OLIVIER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2902 W SWEETWATER AVE APT 1188
PHOENIX AZ
85029-1395
US

IV. Provider business mailing address

2902 W SWEETWATER AVE APT 1188
PHOENIX AZ
85029-1395
US

V. Phone/Fax

Practice location:
  • Phone: 602-301-8726
  • Fax:
Mailing address:
  • Phone: 602-301-8726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-20598
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-17079
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: