MEDICARE: OLIVIA OLIVER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904014771	VA
2	1041C0700X	Clinical Social Worker	SW20764	FL

General Provider Information

NPI Number	:	1033824578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA OLIVER LCSW

Provider Business Mailing Address
First Line	:	9506 WHITEHEART DR
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-9332
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9506 WHITEHEART DR
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-9332
Country	:	US
Telephone Number	:	757-773-9420
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2023
Last Update Date	:	03/24/2026

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