Healthcare Provider Details

I. General information

NPI: 1689367930
Provider Name (Legal Business Name): KATRINA OLIVER LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 07/04/2023
Certification Date: 07/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 GROVE ST
ASHEVILLE NC
28801-3344
US

IV. Provider business mailing address

68 GROVE ST
ASHEVILLE NC
28801-3344
US

V. Phone/Fax

Practice location:
  • Phone: 907-229-5260
  • Fax:
Mailing address:
  • Phone: 907-229-5260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA18710
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: