Provider Demographics
NPI:1891169017
Name:OLIVARES, VERONICA (LCSW)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:OLIVARES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1727
Mailing Address - Country:US
Mailing Address - Phone:201-371-3350
Mailing Address - Fax:
Practice Address - Street 1:71 PARK ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-1434
Practice Address - Country:US
Practice Address - Phone:201-371-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-26
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057695001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical