Healthcare Provider Details

I. General information

NPI: 1710475892
Provider Name (Legal Business Name): CHELSEA OLIVA LHMC, MCAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 NE 1ST AVE
OCALA FL
34470-6654
US

IV. Provider business mailing address

7225 N NEBRASKA AVE
TAMPA FL
33604-4916
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-6565
  • Fax:
Mailing address:
  • Phone: 689-710-6433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14986
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMH14986
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: