Provider Demographics
NPI:1568463255
Name:OLAVE-GUILLERMO, CLAUDIA JANETH (LMSW)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:JANETH
Last Name:OLAVE-GUILLERMO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8429 LORRAINE RD # 249
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-9010
Mailing Address - Country:US
Mailing Address - Phone:845-364-9226
Mailing Address - Fax:845-364-9422
Practice Address - Street 1:7019 BRIER CREEK CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-4215
Practice Address - Country:US
Practice Address - Phone:845-364-9226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR071579-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02128476Medicaid
NY02128476Medicaid
NYNN8451Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #