Provider Demographics
NPI:1154723021
Name:CAROSELLO, OLIVIA HARMAN (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:HARMAN
Last Name:CAROSELLO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:HARMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:8000 BONHOMME AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3515
Mailing Address - Country:US
Mailing Address - Phone:314-312-2702
Mailing Address - Fax:
Practice Address - Street 1:8000 BONHOMME AVE STE 102
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3515
Practice Address - Country:US
Practice Address - Phone:314-312-2702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170081291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical