MEDICARE: JOSEPH OLIVARES LISW-S

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	APS.003984	OH
2	1041C0700X	Clinical Social Worker	I.1303428-SUPV	OH

General Provider Information

NPI Number	:	1811381122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH OLIVARES LISW-S

Provider Business Mailing Address
First Line	:	4800 N SCOTTSDALE RD STE 2500
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7630
Country	:	US
Telephone Number	:	216-468-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 EASTON OVAL STE 115
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-6042
Country	:	US
Telephone Number	:	216-468-5000
Fax Number	:

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

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	08/26/2025

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Directions to “ JOSEPH OLIVARES LISW-S” Practice Location

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