Healthcare Provider Details

I. General information

NPI: 1447058409
Provider Name (Legal Business Name): OLIVIA CARELLI PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 SE MONTEREY COMMONS BLVD STE 205
STUART FL
34996-3357
US

IV. Provider business mailing address

1002 SE MONTEREY COMMONS BLVD STE 205
STUART FL
34996-3357
US

V. Phone/Fax

Practice location:
  • Phone: 772-341-7106
  • Fax:
Mailing address:
  • Phone: 772-341-7106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LEE MCCOY SLOAN
Title or Position: COO
Credential: LCSW
Phone: 561-809-2619