Provider Demographics
NPI:1083725543
Name:OLIVER, SHERRY DIANE (LCSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:DIANE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 S DAVID DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7040
Mailing Address - Country:US
Mailing Address - Phone:405-642-5509
Mailing Address - Fax:405-735-5438
Practice Address - Street 1:3108 S DAVID DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7040
Practice Address - Country:US
Practice Address - Phone:405-642-5509
Practice Address - Fax:405-735-5438
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical