Provider Demographics
NPI:1154127298
Name:O'LEAR, ELIJAH LANE (CSW-A)
Entity type:Individual
Prefix:
First Name:ELIJAH
Middle Name:LANE
Last Name:O'LEAR
Suffix:
Gender:
Credentials:CSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WILDBIRD LN
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2766
Mailing Address - Country:US
Mailing Address - Phone:641-295-0219
Mailing Address - Fax:
Practice Address - Street 1:1902 4TH ST STE 1
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-2558
Practice Address - Country:US
Practice Address - Phone:541-809-1669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker