Provider Demographics
NPI:1073208146
Name:OLIVO THERAPY GROUP
Entity Type:Organization
Organization Name:OLIVO THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:CEASER
Authorized Official - Last Name:OLIVO
Authorized Official - Suffix:II
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-545-6767
Mailing Address - Street 1:290 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-6523
Mailing Address - Country:US
Mailing Address - Phone:973-545-6767
Mailing Address - Fax:
Practice Address - Street 1:290 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-6523
Practice Address - Country:US
Practice Address - Phone:973-545-6767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OLIVO THERAPY GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty