Blackwell, Olivia Shawn

Blackwell, Olivia Shawn is an individual health care provider with primary practice located at 1115 Harber Rd , Grove OK 74344-7818. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Blackwell, Olivia Shawn can be contacted via phone (918) 786-4434.

Contact Information

Primary practice address
1115 Harber Rd Grove OK 74344-7818
Phone: (918) 786-4434
Fax: (918) 786-4435
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1720329188
LBN Legal business name Blackwell, Olivia Shawn
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 11th, 2013
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720329188 NPPES
Oklahoma MEDICAID 100750190L

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