Healthcare Provider Details

I. General information

NPI: 1942048350
Provider Name (Legal Business Name): OLIVIA JEANNE HAMILTON MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 GOLD STAR BLVD
WORCESTER MA
01606-2738
US

IV. Provider business mailing address

77 ELM ST APT 28
WORCESTER MA
01609-2349
US

V. Phone/Fax

Practice location:
  • Phone: 774-994-6649
  • Fax:
Mailing address:
  • Phone: 774-641-0388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2140758
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: