Healthcare Provider Details

I. General information

NPI: 1235052028
Provider Name (Legal Business Name): DIANA OLIDE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 W 44TH AVE
WHEAT RIDGE CO
80033-3006
US

IV. Provider business mailing address

9201 W 44TH AVE
WHEAT RIDGE CO
80033-3006
US

V. Phone/Fax

Practice location:
  • Phone: 720-551-4269
  • Fax:
Mailing address:
  • Phone: 720-551-4269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0023924
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: