Provider Demographics
NPI:1235795931
Name:WOODWARD, OLIVIA GRACE (LCPC, LMHC, ATR)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:GRACE
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:LCPC, LMHC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 E GORDON ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2916
Mailing Address - Country:US
Mailing Address - Phone:104-838-9000
Mailing Address - Fax:
Practice Address - Street 1:44 E GORDON ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2916
Practice Address - Country:US
Practice Address - Phone:104-838-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10858101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional