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NPI 1548076508

NPI 1548076508 : OLIVER BEHAVIORAL CONSULTANTS LLC : DELTA, CO

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General NPI Number Information
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    NPI Number           |    1548076508
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    Entity Type          |    Organization 
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    Legal Business Name  |    OLIVER BEHAVIORAL CONSULTANTS LLC 
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Dates
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    Enumeration Date     |    12/05/2024
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    Last Update Date     |    12/05/2024
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Provider Practice Location Address
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    Address Line         |    543 MAIN ST 
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    City                 |    DELTA
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    State                |    CO
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    Zip                  |    81416-1817
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    Country              |    US
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    Telephone            |    720-459-7493
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    550 THORNTON PKWY UNIT 234 
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    City                 |    THORNTON
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    State                |    CO
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    Zip                  |    80229-2167
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ADMINISTRATIVE DIRECTOR
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    Name                 |     WALESHKA  MELO 
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    Credential           |    
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    Telephone            |    720-459-7493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    103TB0200X
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    Taxonomy Name        |    Cognitive & Behavioral Psychologist
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    License Number       |    
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    License Number State |    
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Taxonomy #5
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    
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    License Number State |    
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Taxonomy #6
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    Taxonomy Code        |    103TC1900X
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    Taxonomy Name        |    Counseling Psychologist
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    License Number       |    
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    License Number State |    
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Taxonomy #7
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    Taxonomy Code        |    103TM1800X
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    Taxonomy Name        |    Intellectual & Developmental Disabilities Psychologist
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    License Number       |    
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    License Number State |    
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Taxonomy #8
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    Taxonomy Code        |    103TP2701X
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    Taxonomy Name        |    Group Psychotherapy Psychologist
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    License Number       |    
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    License Number State |    
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Taxonomy #9
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    
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    License Number State |    
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Taxonomy #10
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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Taxonomy #11
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    Taxonomy Code        |    106E00000X
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    Taxonomy Name        |    Assistant Behavior Analyst
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    License Number       |    
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    License Number State |    
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Taxonomy #12
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #13
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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Taxonomy #14
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    
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    License Number State |    
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