Healthcare Provider Details

I. General information

NPI: 1013590157
Provider Name (Legal Business Name): OLIVIA NIEVES LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 W YAMATO RD APT 306
BOCA RATON FL
33431-4482
US

IV. Provider business mailing address

789 W YAMATO RD APT 306
BOCA RATON FL
33431-4482
US

V. Phone/Fax

Practice location:
  • Phone: 717-798-6583
  • Fax:
Mailing address:
  • Phone: 717-798-6583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC013126
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH22173
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: