Angela D. Oliver, LCSW

Individual provider Active NPI Clinical Social Worker · El Prado, NM

NPI 1003008202 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1003008202
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C-06235 (NM)
Practice address
244 Tune Drive
El Prado, NM 87529
Phone
(575) 751-9858
Fax
(575) 751-9858
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
I-06235NMMDMental Health Counselor
C-06235NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nonviolence Works, Inc. Past
since Mar 2, 2018
Accepting new patients
Sangre de Cristo Community Health Partnership Mental Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X I-06235 NM
Clinical Social Worker 1041C0700X C-06235 NM Yes

Addresses

Primary practice location

244 Tune Drive
El Prado, NM 87529

Mailing address

PO Box 278
El Prado, NM 87529-0278
Phone (575) 751-9858

Other practice location 1

320 Paseo Del Pueblo Sur Ste B
Taos, NM 87571-5021
Phone (575) 613-6789

Other identifiers

IdentifierTypeStateIssuer
99881365MedicaidNM

Other providers in El Prado, NM

All providers in El Prado, NM · Clinical Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.