Provider Demographics
NPI:1154768125
Name:BASKIN, OLIVIA MARLENE (LCSW)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MARLENE
Last Name:BASKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:SKOPAL
Other - Last Name:BASKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:7011 ASPEN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-2756
Mailing Address - Country:US
Mailing Address - Phone:214-769-0737
Mailing Address - Fax:972-398-9837
Practice Address - Street 1:12700 HILLCREST RD
Practice Address - Street 2:274
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2033
Practice Address - Country:US
Practice Address - Phone:972-233-1010
Practice Address - Fax:972-233-1099
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX568101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical