Provider Demographics
NPI:1700254760
Name:OLINGER, LISA (LMSW, MA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:OLINGER
Suffix:
Gender:F
Credentials:LMSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W MERRILL ST STE 240
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1443
Mailing Address - Country:US
Mailing Address - Phone:734-658-7056
Mailing Address - Fax:
Practice Address - Street 1:550 W MERRILL ST STE 240
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-1443
Practice Address - Country:US
Practice Address - Phone:734-658-7056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2019-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program