| Kristi Deroy-olivero Licsw Inc. | |
|
37 Myrtle Ave Holyoke MA 01040-3513 | |
| (413) 207-2803 | |
| Not Available |
| Full Name | Kristi Deroy-olivero Licsw Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 37 Myrtle Ave, Holyoke, Massachusetts |
| Authorized Official Name and Position | Kristi Olivero (CLINICIAN) |
| Authorized Official Contact | 4132072803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristi Deroy-olivero Licsw Inc. 6 Holly Meadow Rd Holyoke MA 01040-9775 Ph: (413) 207-2803 | Kristi Deroy-olivero Licsw Inc. 37 Myrtle Ave Holyoke MA 01040-3513 Ph: (413) 207-2803 |
| NPI Number | 1245008093 |
|---|---|
| Provider Enumeration Date | 12/12/2023 |
| Last Update Date | 12/12/2023 |
| Certification Date | 12/12/2023 |
| Medicare PECOS PAC ID | 9739530882 |
|---|---|
| Medicare Enrollment ID | O20240112002417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245008093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristi L Olivero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578882775 PECOS PAC ID: 0446493134 Enrollment ID: I20130828000361 |
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