Provider Demographics
NPI:1568757573
Name:OLIVERAS, CAROLYN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:OLIVERAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CALLE FLOR DE LUZ
Mailing Address - Street 2:URB. LOS JARDINES
Mailing Address - City:GARROCHALES
Mailing Address - State:PR
Mailing Address - Zip Code:00652-9418
Mailing Address - Country:US
Mailing Address - Phone:787-466-9986
Mailing Address - Fax:
Practice Address - Street 1:CALLE FLOR DE LUZ 291
Practice Address - Street 2:URB. LOS JARDINES
Practice Address - City:GARROCHALES
Practice Address - State:PR
Practice Address - Zip Code:00652-9418
Practice Address - Country:US
Practice Address - Phone:787-466-9986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR82311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical