Provider Demographics
NPI:1316356017
Name:OLON, MAGGIE R (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:R
Last Name:OLON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 N 2ND ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-1254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:98 N 2ND ST
Practice Address - Street 2:STE 100
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1254
Practice Address - Country:US
Practice Address - Phone:315-326-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088064104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker