MEDICARE: PATRICIA OLACHEA LPC

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	101YP2500X	Professional Counselor	19161	TX

General Provider Information

NPI Number	:	1912036898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA OLACHEA LPC

Provider Business Mailing Address
First Line	:	2600 S SHORE BLVD
Second Line	:	SUITE 300
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2943
Country	:	US
Telephone Number	:	281-668-9151
Fax Number	:	281-668-9152

Provider Business Practice Location Address
First Line	:	2600 S SHORE BLVD
Second Line	:	SUITE 300
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2943
Country	:	US
Telephone Number	:	281-668-9151
Fax Number	:	281-668-9152

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/09/2007

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