MEDICARE: DESTINY RENEE OLVERA LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CTB-2025-0070	NM

General Provider Information

NPI Number	:	1346046307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTINY RENEE OLVERA LMHC

Provider Business Mailing Address
First Line	:	4717 HONDO PASS DR # 1D3085
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-1474
Country	:	US
Telephone Number	:	915-229-4498
Fax Number	:

Provider Business Practice Location Address
First Line	:	4717 HONDO PASS DR # 1D3085
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-1474
Country	:	US
Telephone Number	:	915-229-4498
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2025
Last Update Date	:	09/24/2025

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