Provider Demographics
NPI:1336329119
Name:OLIVEIRA, MELANIE MARION (LCSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:MARION
Last Name:OLIVEIRA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:DORI
Other - Last Name:MARION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:
Mailing Address - City:TRIPLER ARMY MEDICAL CENTER
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-8600
Mailing Address - Fax:
Practice Address - Street 1:354 ULUNIU ST
Practice Address - Street 2:# 203A
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2528
Practice Address - Country:US
Practice Address - Phone:808-745-6123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00050599101YP2500X
WALW601258841041C0700X
HI39481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional