Provider Demographics
NPI:1558748632
Name:OLAVARRIA, DANIEL (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:OLAVARRIA
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 PARK AVE S
Mailing Address - Street 2:PMB 16968
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1502
Mailing Address - Country:US
Mailing Address - Phone:646-760-8421
Mailing Address - Fax:646-921-9525
Practice Address - Street 1:228 PARK AVE S
Practice Address - Street 2:PMB 16968
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1502
Practice Address - Country:US
Practice Address - Phone:646-760-8421
Practice Address - Fax:646-921-9525
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093724104100000X
NY0860601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker