Marylu A. Olson, LICSW
Individual provider Active NPI Social Worker · Brattleboro, VT
NPI 1124348974 · NPPES record last updated Feb 10, 2017
Key facts
- NPI
- 1124348974
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 089.0098673 (VT)
- Practice address
- 51 Fairview Street
Health Care and Rehabilitation Services of SE VT, Inc.
Brattleboro, VT 05301 - Phone
- (802) 254-7500
- Fax
- (802) 254-7501
- NPI assigned
- Jun 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 351083-3501 | UT | |
| Social Worker | 104100000X | 089.0098673 | VT | Yes |
Addresses
Primary practice location
51 Fairview Street
Health Care and Rehabilitation Services of SE VT, Inc.
Brattleboro, VT 05301
Mailing address
390 River St
Health Care and Rehabilitation Services of SE VT, Inc.
Springfield, VT 05156-2226
Phone (802) 886-4567
Other providers in Brattleboro, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.