Provider Demographics
NPI:1194872663
Name:OLSHEVER, DEBRA NANCY (MED, LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:NANCY
Last Name:OLSHEVER
Suffix:
Gender:F
Credentials:MED, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 WALNUT STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEWTON HIGHLANDS
Mailing Address - State:MA
Mailing Address - Zip Code:02461
Mailing Address - Country:US
Mailing Address - Phone:617-965-9369
Mailing Address - Fax:
Practice Address - Street 1:1163 WALNUT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NEWTON HIGHLANDS
Practice Address - State:MA
Practice Address - Zip Code:02461-1265
Practice Address - Country:US
Practice Address - Phone:617-965-9369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104 (EDUC. PSYCH)101YM0800X
MA201058 (LCSW)1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical