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Individual
OLIVIA LAKES
Active
Individual
OLIVIA LAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LG50083251
DC
1041C0700X
Clinical Social Worker
LC200002485
DC
1041C0700X
Clinical Social Worker
Primary
LICSW1120799
MA
Other
Enumeration date
02/08/2022
Last updated
09/02/2026
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