Provider Demographics
NPI:1487646782
Name:OLIVIER, MICHEL PHILIPPE (LICSW)
Entity Type:Individual
Prefix:MR
First Name:MICHEL
Middle Name:PHILIPPE
Last Name:OLIVIER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 D ST
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-2162
Mailing Address - Country:US
Mailing Address - Phone:978-455-5204
Mailing Address - Fax:978-455-8320
Practice Address - Street 1:176 D ST
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-2162
Practice Address - Country:US
Practice Address - Phone:978-455-5204
Practice Address - Fax:978-455-8320
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10239231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO7049Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER