Individual provider Active NPI

Kristi Olivero, LICSW

  • Mental Health Counselor
  • Holyoke, MA
National Provider Identifier
1578882775
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1789 Northampton St
Holyoke, MA 01040-1920
Phone
(413) 207-2803
NPI assigned
May 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1789 Northampton St
Holyoke, MA 01040-1920

Mailing address

1789 Northampton St
Holyoke, MA 01040-1920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130828000361 MA Practitioner - Clinical Social Worker 0446493134 Reassigns benefits to 1 organization
Practice locations: Holyoke, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

37 Myrtle Ave
Holyoke, MA 01040-3513
Phone (413) 207-2803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kristi Deroy-Olivero Licsw Inc. CurrentSince Dec 1, 2023 Accepting new patients

Locations

37 Myrtle Ave
Holyoke, MA 01040
Phone (413) 207-2803

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1578882775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1789 NORTHAMPTON ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010401920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1789 NORTHAMPTON ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010401920",
            "telephone_number": "413-207-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERO",
        "first_name": "KRISTI",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.