Provider Demographics
NPI:1558487751
Name:OLIVER, JOY W (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:W
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HAWTHORNE LN
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-2755
Mailing Address - Country:US
Mailing Address - Phone:207-838-0188
Mailing Address - Fax:
Practice Address - Street 1:103 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2755
Practice Address - Country:US
Practice Address - Phone:207-838-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC99021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME098781OtherANTHEM BEHAVIORAL HEALTH