Michael Phillip Oliver

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW0000007372 Issued in TN

Practice address

4455 Allen LN Ste 130
North Las Vegas, NV 89031-2208

Phone

(702) 385-1072

Fax

(702) 385-3053

NPI assigned

Sep 20, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• LDS Family Services

  • Community/Behavioral Health Agency
  • North Las Vegas, NV
  • NPI 1790990349
  NPD (past)

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1649521436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 NARCISSUS DR",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381351492",
            "telephone_number": "615-810-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 ALLEN LN STE 130",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890312208",
            "telephone_number": "702-385-1072",
            "fax_number": "702-385-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "MICHAEL",
        "middle_name": "PHILLIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-20",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "10161-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C9757",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000007372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asaf Olivas Estebane
• Olive Branch Mentoring
• Olive Branch Supportive Services LLC
• Demarrius Oliver
• Margaret Marie Oliver, LCSW
• Jailon Javier Olivera Lopez
• Miguel M Ollada, MD
• Lori Olson
• Bibi Omar, M.D.
• Nicole Yvette Rosales Onas, M.S., CCC-SLP

• Clinical Social Worker in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.