Ciro Thomas Olivares, MSW

Individual provider Active NPI Clinical Social Worker · Pittsfield, ME

NPI 1164580957 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1164580957
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LC1228 (ME)
Practice address
12 Waverly Avenue
Pittsfield, ME 04967
Phone
(207) 623-8411
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

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
LC1228MEMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC1228 ME Yes

Addresses

Primary practice location

12 Waverly Avenue
Pittsfield, ME 04967

Mailing address

12 Waverly Ave
Pittsfield, ME 04967-1118
Phone (207) 623-8411

Other providers in Pittsfield, ME

All providers in Pittsfield, ME · Clinical Social Worker in Maine

Sources for this page

Verify at the official NPI Registry.