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General NPI Number Information
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NPI Number | 1457877292
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Entity Type | Individual
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Provider Name | OLIVIA TURSI LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 1130 N BROADWAY STE 210
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City | MASSAPEQUA
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State | NY
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Zip | 11758-1304
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Country | US
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Telephone | 516-532-8201
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Fax |
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Provider Business Mailing Address
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Address Line | 6615 THORNTON PL APT 4A
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City | REGO PARK
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State | NY
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Zip | 11374-5151
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Country | US
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Telephone | 516-532-8201
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 079998
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License Number State | NY
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