Provider Demographics
NPI:1881462869
Name:OLGERS, EMMA ELLIS (LMSW)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:ELLIS
Last Name:OLGERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 BROAD ROCK BLVD.,
Mailing Address - Street 2:ATTN: 122-SOCIAL WORK GREEN CLINIC PACT
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-0001
Mailing Address - Country:US
Mailing Address - Phone:804-738-1692
Mailing Address - Fax:
Practice Address - Street 1:1201 BROAD ROCK BLVD.,
Practice Address - Street 2:ATTN: 122-SOCIAL WORK GREEN CLINIC PACT
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-738-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0903004062104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker