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NPI Code Detail

MEDICARE: VIRGINIA MERCEDES BETANCOURT OLIVAREZ LMSW

MEDICARE: VIRGINIA MERCEDES BETANCOURT OLIVAREZ LMSW
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1043784572
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIRGINIA MERCEDES BETANCOURT OLIVAREZ LMSW
Provider Business Mailing Address
First Line : 1000 HOUGHTON AVE
Second Line :
City : SAGINAW
State : MI
Zip : 48602-5303
Country : US
Telephone Number : 989-746-7952
Fax Number : 989-746-7723
Provider Business Practice Location Address
First Line : 1217 S EUCLID AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48706-3311
Country : US
Telephone Number : 989-667-9661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2019
Last Update Date : 03/30/2026

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