Janet S Oliver, LPCC

Individual provider Active NPI Professional Counselor · Angel Fire, NM

NPI 1255435608 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1255435608
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
91521 (NM)
Practice address
09 Llano Vista Rd
Black Lake Division
Angel Fire, NM 87710
Phone
(505) 377-3193
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
91521NMMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 91521 NM Yes

Addresses

Primary practice location

09 Llano Vista Rd
Black Lake Division
Angel Fire, NM 87710

Mailing address

P.O. Box 1319
Angel Fire, NM 87710
Phone (505) 377-3193

Other identifiers

IdentifierTypeStateIssuer
42980844MedicaidNM

Other providers in Angel Fire, NM

All providers in Angel Fire, NM · Professional Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.