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NPI Code Detail

MEDICARE: JULIA OLIVER L.C.M.H.C.

MEDICARE: JULIA OLIVER L.C.M.H.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor6401008736MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
161416OTHERVTMVP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
300018781OTHERVTBLUE CROSS BLUE SHIELD
42033039OTHERVTCIGNA

General Provider Information

NPI Number : 1841248176
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA OLIVER L.C.M.H.C.
Provider Business Mailing Address
First Line : 43825 MICHIGAN AVE
Second Line :
City : CANTON
State : MI
Zip : 48188-2551
Country : US
Telephone Number : 734-397-3088
Fax Number : 734-397-2892
Provider Business Practice Location Address
First Line : 43825 MICHIGAN AVE
Second Line :
City : CANTON
State : MI
Zip : 48188-2551
Country : US
Telephone Number : 734-397-3088
Fax Number : 734-397-2892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 07/09/2007

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