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MR. MARIO BOLIVAR JR. LCSW
NPI 1639304934
Social Worker - Clinical in Dallas, GA

Active since May 15, 2009
112 CREEKSIDE DR, DALLAS, GA 30157(678) 237-1269 Get Directions Write a Review

NPPES record last updated: May 15, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Mario Bolivar Jr. Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MARIO BOLIVAR JR. LCSW (NPI 1639304934) is an individual clinical provider in Dallas, Georgia, licensed in Florida (3071) and active in the NPI registry since May 2009.

NPPES Registry Identity

NPI1639304934
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. MARIO BOLIVAR JR.Credential: LCSW
Location Address112 CREEKSIDE DRDallas, GA 30157-7370
Mailing Address112 Creekside DrDallas, GA 30157-7370 · (678) 237-1269
Phone(678) 237-1269
Sole ProprietorYes
Enumeration DateMay 15, 2009
✔ NPI 1639304934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in FL · 3071✔ Licensed in OR · 1214
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
112 CREEKSIDE DR, Dallas, GA 30157
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Other Names 1

Professional Name (2)Mario Bolivar Lcsw

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mario Bolivar's NPI number?

The NPI number for Mario Bolivar is 1639304934. It was assigned to this individual provider in the NPPES registry on May 15, 2009. The provider is also known as Mario Bolivar Lcsw.

Where is Mario Bolivar located?

Mario Bolivar practices at 112 Creekside Dr, Dallas, GA 30157. The listed phone number is (678) 237-1269.

What is Mario Bolivar's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Mario Bolivar was last updated on May 15, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.