THEODORE OLIVER (LCSW) – Clinical Social Worker, NPI 1508905498

THEODORE OLIVER (LCSW) is a healthcare provider. based in Hannibal, Missouri. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 004830 (MO). The NPI Number for THEODORE OLIVER (LCSW) is 1508905498

Main info

Male
48 Years Of Experience
Accepts Medicare Assignment
Name
THEODORE OLIVER (LCSW)
NPI
1508905498
Phone
(573) 221-2120
Address
917 BROADWAY
Enumeration Date
6 February 2007
Last Update Date
9 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5732212120
Graduation Year
1978 (48 years ago)
PAC ID
6002127123
Group Practice PAC ID
9436376969
Professional Enrollment ID
I20150616002210
Address ID
MO634015511HA154XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,245 CLINICAL SOCIAL WORKER in MO

Provider Addresses for THEODORE OLIVER (LCSW)

  • 917 BROADWAY

    PO BOX 708

    HANNIBAL, MO 634014200

    Phone: (573) 221-2120

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150616002210IClinical Social WorkerMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour6616$0
View full utilization report →

Insurance plans in this area (ZIP 63401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436376969View full group profile
NameSpecialtyState
Mental Health CounselorMO
-IL
Clinical Social WorkerMO
Mental Health CounselorMO
Mental Health CounselorMO
-MO
Clinical Social WorkerMO
P S Y C H I A T R YMO
Mental Health CounselorMO
Clinical Social WorkerMO

Reviews

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Frequently asked questions

Can I verify THEODORE OLIVER (LCSW) with an NPI only?
You can start verification with NPI 1508905498 for THEODORE OLIVER (LCSW), then check state licensing separately.
Is THEODORE OLIVER (LCSW) still practicing?
THEODORE OLIVER (LCSW) is currently listed as active in the public NPI registry.
What taxonomy line describes THEODORE OLIVER (LCSW)?
For research purposes, treat THEODORE OLIVER (LCSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
Does THEODORE OLIVER (LCSW) list a practice location?
Patients near Hannibal, Missouri may find THEODORE OLIVER (LCSW) in results; validate coverage separately.
Is the information about THEODORE OLIVER (LCSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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