MEDICARE: SARAH MARIE OLIVER 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
1	104100000X	Social Worker	10818	SC
2	104100000X	Social Worker	3720G	AL

General Provider Information

NPI Number	:	1467836312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MARIE OLIVER LMSW

Provider Business Mailing Address
First Line	:	167 BLUFFTON RD STE C
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-6228
Country	:	US
Telephone Number	:	843-757-7500
Fax Number	:	843-757-7510

Provider Business Practice Location Address
First Line	:	167 BLUFFTON RD STE C
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-6228
Country	:	US
Telephone Number	:	843-757-7500
Fax Number	:	843-757-7510

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

Provider Enumeration Date	:	07/09/2015
Last Update Date	:	07/09/2015

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