Healthcare Provider Details

I. General information

NPI: 1033616800
Provider Name (Legal Business Name): TIFFANI OLENIK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EAST AVE
NORWALK CT
06851-5010
US

IV. Provider business mailing address

226 PINESBRIDGE RD
MILLWOOD NY
10546-1131
US

V. Phone/Fax

Practice location:
  • Phone: 203-494-7811
  • Fax:
Mailing address:
  • Phone: 914-941-5185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number087173-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number010319
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: