MEDICARE: HEATHER OLIVER LISW-CP LLC

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

General Provider Information

NPI Number	:	1104422534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEATHER OLIVER LISW-CP LLC

Provider Business Mailing Address
First Line	:	1121 PARK WEST BLVD STE B
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-7122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1448 THAYER PL
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-9029
Country	:	US
Telephone Number	:	843-996-0331
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HEATHER OLIVER
Credential	:	LISW-CP
Telephone Number	:	843-996-0331

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	01/22/2026

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