Provider Demographics
NPI:1033303144
Name:OLIVER, STEPHANIE YOLANDA (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:YOLANDA
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 MARY AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-2631
Mailing Address - Country:US
Mailing Address - Phone:410-488-4717
Mailing Address - Fax:410-488-3757
Practice Address - Street 1:4305 MARY AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-2631
Practice Address - Country:US
Practice Address - Phone:410-488-4717
Practice Address - Fax:410-488-3757
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical