Active NPI
Mark Allan Oliver, LISW-CP, PHD
- Clinical Social Worker
- Jbsa Lackland, TX
National Provider Identifier
1225005499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6622
- Practice address
- 1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236 - Phone
- (210) 292-5859
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6622 | SC | Primary |
Addresses
Primary practice location
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236
Mailing address
11006 Chicory FLD
Helotes, TX 78023-3620
Phone (719) 433-8664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6622 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587513600000",
"number": "1225005499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11006 CHICORY FLD",
"city": "HELOTES",
"state": "TX",
"postal_code": "780233620",
"telephone_number": "719-433-8664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP BLDG 4554",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "78236",
"telephone_number": "210-292-5859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "MARK",
"middle_name": "ALLAN",
"name_prefix": "Mr.",
"credential": "LISW-CP, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2020-04-22",
"certification_date": "2020-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "6622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.