Provider Demographics
NPI:1801386354
Name:OLIVIERI, GRACE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:OLIVIERI
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15210 DINO DR UNIT 715
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-7532
Mailing Address - Country:US
Mailing Address - Phone:240-704-1707
Mailing Address - Fax:
Practice Address - Street 1:3805 STEPPING STONE LN
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1936
Practice Address - Country:US
Practice Address - Phone:443-620-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23671104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker