Provider Demographics
NPI:1285136309
Name:SLIWA, OLGA KRAVCHENKO (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:KRAVCHENKO
Last Name:SLIWA
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-3406
Mailing Address - Country:US
Mailing Address - Phone:781-329-8390
Mailing Address - Fax:
Practice Address - Street 1:93 WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-2755
Practice Address - Country:US
Practice Address - Phone:617-730-2768
Practice Address - Fax:617-730-2761
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1067031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical