Provider Demographics
NPI:1245008093
Name:KRISTI DEROY-OLIVERO LICSW INC.
Entity type:Organization
Organization Name:KRISTI DEROY-OLIVERO LICSW INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:413-207-2803
Mailing Address - Street 1:6 HOLLY MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-9775
Mailing Address - Country:US
Mailing Address - Phone:413-207-2803
Mailing Address - Fax:
Practice Address - Street 1:37 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-3513
Practice Address - Country:US
Practice Address - Phone:413-207-2803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty