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General NPI Number Information
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NPI Number | 1588104525
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Entity Type | Organization
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Legal Business Name | OLIVE TREE COUNSELING, LLC
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 10200 E GIRARD AVE D218
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City | DENVER
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State | CO
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Zip | 80231-5500
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Country | US
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Telephone | 720-722-1825
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Fax |
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Provider Business Mailing Address
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Address Line | 10200 E GIRARD AVE D218
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City | DENVER
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State | CO
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Zip | 80231-5500
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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 | OWNER
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Name | OLIVIA CICHON
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Credential | MAC LAC
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Telephone | 720-722-1825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 278
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License Number State | CO
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