Provider Demographics
NPI:1821406422
Name:OLSHAN, ALYESHA (LSW, MSW)
Entity Type:Individual
Prefix:
First Name:ALYESHA
Middle Name:
Last Name:OLSHAN
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:2501 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4890
Practice Address - Country:US
Practice Address - Phone:717-735-1954
Practice Address - Fax:717-569-3045
Is Sole Proprietor?:No
Enumeration Date:2014-07-27
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0185861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103755317Medicaid
PACW018586OtherSTATE LICENSE
12708282OtherCAQH