Provider Demographics
NPI:1255783361
Name:SULLIVAN, OLIVIA MCMASTER (LCSW)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MCMASTER
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:MCMASTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8042 IRIS CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-2138
Mailing Address - Country:US
Mailing Address - Phone:631-241-3919
Mailing Address - Fax:
Practice Address - Street 1:8042 IRIS CT
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-2138
Practice Address - Country:US
Practice Address - Phone:631-241-3919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099261001041C0700X
NY0841971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical