Provider Demographics
NPI:1669670683
Name:CREARY, OLIVIA (LCSW)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:CREARY
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:BROWARD COMMUNITY AND FAMILY HEALTH CENTERS INC
Mailing Address - Street 2:168 NORTH POWERLINE ROAD
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BROWARD COMMUNITY AND FAMILY HEALTH CENTERS, INC.
Practice Address - Street 2:168 NORTH POWERLINE ROAD
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33021-3205
Practice Address - Country:US
Practice Address - Phone:954-967-0028
Practice Address - Fax:954-272-0294
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 64501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW 6450OtherSTATE OF FLORIDA DEPARTME