Provider Demographics
NPI:1871646125
Name:OLIVER, CARRIE (MSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 E YALE AVE
Mailing Address - Street 2:#F105
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-6055
Mailing Address - Country:US
Mailing Address - Phone:720-244-2433
Mailing Address - Fax:
Practice Address - Street 1:105 W CALVIN ST
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-7403
Practice Address - Country:US
Practice Address - Phone:800-539-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11961041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012235000Medicaid