Provider Demographics
NPI:1730646175
Name:OLIVER, CAPRISHEUS (LCSW)
Entity Type:Individual
Prefix:
First Name:CAPRISHEUS
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAPRISHEUS
Other - Middle Name:OLIVER
Other - Last Name:BARBEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5116 WEXFORD RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-2264
Mailing Address - Country:US
Mailing Address - Phone:317-766-3117
Mailing Address - Fax:
Practice Address - Street 1:3815 RIVER CROSSING PKWY STE 100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-7766
Practice Address - Country:US
Practice Address - Phone:317-766-3117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300061327Medicaid