Olivia Wardlaw, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P016950 Issued in NC

Practice address

4036 Bus 17
East BLDG 600
Bolivia, NC 28337

Phone

(910) 703-8822

Fax

(910) 754-3439

NPI assigned

Jan 13, 2022

Last updated

Apr 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1396496139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 BUS 17",
            "address_2": "EAST BLDG 600",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-703-8822",
            "fax_number": "910-754-3439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Shipyard Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284126431",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Coastal Horizons Dr",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284706094",
            "country_code": "US",
            "telephone_number": "910-754-4515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARDLAW",
        "first_name": "OLIVIA",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashly Valas, M.A. CCC-SLP
• Miller J Van Vliet, DO
• Hannah Leann Vaughn, M.A., CCC-SLP
• Erin Nicole Wallace
• Jonathan Ward, M.D.
• Michael D Watson, PA-C
• Kara Anne Weatherford, FNP
• Ryleigh Weber, MS
• Carolyn Whitfield
• Lillie Williams, LCAS-A

• Clinical Social Worker in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.