Healthcare Provider Details

I. General information

NPI: 1659135903
Provider Name (Legal Business Name): DIANA OLIVARES MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14901 E HAMPDEN AVE STE 100
AURORA CO
80014-5037
US

IV. Provider business mailing address

14901 E HAMPDEN AVE STE 100
AURORA CO
80014-5037
US

V. Phone/Fax

Practice location:
  • Phone: 720-260-4115
  • Fax:
Mailing address:
  • Phone: 720-260-4115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0023961
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: