MEDICARE: WHITNEY OLIVER

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LICDC.161819	OH
2	101YM0800X	Mental Health Counselor	E.1901101	OH
3	101YP2500X	Professional Counselor	E.1901101	OH

General Provider Information

NPI Number	:	1831687086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY OLIVER

Provider Business Mailing Address
First Line	:	1173 N RIDGE RD E STE 102
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-3032
Country	:	US
Telephone Number	:	440-233-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1173 N RIDGE RD E STE 102
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-3032
Country	:	US
Telephone Number	:	440-233-7400
Fax Number	:

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

Provider Enumeration Date	:	04/24/2018
Last Update Date	:	07/08/2025

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Directions to “ WHITNEY OLIVER ” Practice Location

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