Provider Demographics
NPI:1578130100
Name:EUSDEN, OLIVIA BRODSKY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:BRODSKY
Last Name:EUSDEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1228
Mailing Address - Country:US
Mailing Address - Phone:781-223-5193
Mailing Address - Fax:
Practice Address - Street 1:153 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1228
Practice Address - Country:US
Practice Address - Phone:781-223-5193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1233861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty