Healthcare Provider Details

I. General information

NPI: 1437971009
Provider Name (Legal Business Name): HONESTLY OLIVE COUNSELING AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E ENTERPRISE AVE STE 333
APPLETON WI
54913-7889
US

IV. Provider business mailing address

8569 N ORCHARD CT
SPOKANE WA
99208-6954
US

V. Phone/Fax

Practice location:
  • Phone: 414-502-9023
  • Fax:
Mailing address:
  • Phone: 414-502-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEV ILDIZ
Title or Position: FOUNDER/CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 414-502-9023