Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Mario Bolivar Jr., LCSW

Individual provider Clinical Social Worker · NPI 1639304934

Mr. Mario Bolivar Jr., LCSW is a Clinical Social Worker in Dallas, Georgia. Practices as a sole proprietor. Licensed in Florida and Oregon.

Licensed in
FL, OR
In the registry since
2009
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

112 Creekside Dr
Dallas, GA 30157-7370
Phone: (678) 237-1269
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 3071 (FL)
Clinical Social Worker Taxonomy 1041C0700X · Licence 1214 (OR)

Record details

NPI number1639304934
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMay 15, 2009
Last updated in NPPESMay 15, 2009

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