=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184959439
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELISE PEARL OLIVER MSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2009
-----------------------------------------------------
Last Update Date | 10/05/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 914 MT. KEMBLE AVE. SUITE 305
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-425-9900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 914 MT. KEMBLE AVE. SUITE 305
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-425-9900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 44SC00386300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------