Provider Demographics
NPI:1518266782
Name:OLIVEWOOD COUNSELING
Entity Type:Organization
Organization Name:OLIVEWOOD COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:K
Authorized Official - Last Name:RICHENDOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:610-417-0463
Mailing Address - Street 1:3530 RUTGERS DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-1465
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 BATH PIKE
Practice Address - Street 2:SUITE 510
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2466
Practice Address - Country:US
Practice Address - Phone:610-417-0463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-27
Last Update Date:2011-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0169501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty