Organization Active NPI

Olivo Therapy Group

  • Psychologist
  • Newark, NJ
National Provider Identifier
1902306715
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
OLIVO THERAPY GROUP
Practice address
290 Chestnut St
Newark, NJ 07105
Phone
(973) 545-6767
NPI assigned
Feb 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Authorized official

Name
Dr. Julio Ceaser Olivo II, PHDNPI 1215437025
Title
Psychologist/Owner
Phone
(973) 545-6767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

290 Chestnut St
Newark, NJ 07105

Mailing address

1112 Thirza PL
Rahway, NJ 07065-2707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180417000172 NJ Part B Supplier - Clinic/Group Practice 3577826007 Receives reassigned benefits from 2 practitioners
Practice locations: Newark, NJ

National Provider Directory

National Provider Directory
Tax ID family
Olivo Therapy Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1902306715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 THIRZA PL",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CHESTNUT ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07105",
            "telephone_number": "973-545-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVO THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "OLIVO",
        "authorized_official_first_name": "JULIO",
        "authorized_official_middle_name": "CEASER",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "973-545-6767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.