| Olivo Therapy Group | |
|
290 Chestnut St Newark NJ 07105 | |
| (973) 545-6767 | |
| Not Available |
| Full Name | Olivo Therapy Group |
|---|---|
| Speciality | Psychologist |
| Location | 290 Chestnut St, Newark, New Jersey |
| Authorized Official Name and Position | Julio Ceaser Olivo (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 9735456767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olivo Therapy Group 1112 Thirza Pl Rahway NJ 07065-2707 Ph: () - | Olivo Therapy Group 290 Chestnut St Newark NJ 07105 Ph: (973) 545-6767 |
| NPI Number | 1902306715 |
|---|---|
| Provider Enumeration Date | 02/19/2018 |
| Last Update Date | 07/16/2018 |
| Medicare PECOS PAC ID | 3577826007 |
|---|---|
| Medicare Enrollment ID | O20180417000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902306715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Julio C Olivo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215437025 PECOS PAC ID: 4486917911 Enrollment ID: I20180417000207 |
| Provider Name | Ashley Virginia Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679239594 PECOS PAC ID: 2466892765 Enrollment ID: I20240503001519 |
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