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NPI Code Detail

MEDICARE: JOHN W OLIVER LSW

MEDICARE:   JOHN W OLIVER  LSW
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
1171M00000XCase Manager/Care Coordinator
2104100000XSocial WorkerS.2106098OH

General Provider Information

NPI Number : 1992330450
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN W OLIVER LSW
Provider Business Mailing Address
First Line : 1531 HILLCREST RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44118-2429
Country : US
Telephone Number : 216-501-1243
Fax Number :
Provider Business Practice Location Address
First Line : 1531 HILLCREST RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44118-2429
Country : US
Telephone Number : 216-501-1243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2020
Last Update Date : 05/02/2022

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Directions to “ JOHN W OLIVER LSW” Practice Location

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