Alicia Carmen Olivares, MS, PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11233 Issued in FL

Practice address

21 B St
Haines City, FL 33844-5025

Phone

(321) 442-6665

Fax

(800) 883-7015

NPI assigned

Dec 18, 2012

Last updated

Aug 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Professional Counseling Associates Center

  • Case Management Agency
  • Haines City, FL
  • NPI 1790350502
  NPD Authorized official
• Professional Counseling Associates Center

  • Mental Health Counselor
  • Kissimmee, FL
  • NPI 1821468539

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Professional Counseling LLC

  • Community/Behavioral Health Agency
  • Kissimmee, FL
  • NPI 1831434489
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1417293556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 B ST",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338445025",
            "telephone_number": "321-442-6665",
            "fax_number": "800-883-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 B ST",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338445025",
            "telephone_number": "321-442-6665",
            "fax_number": "800-883-7015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "316 N John Young Pkwy Ste 4",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414981",
            "country_code": "US",
            "telephone_number": "321-442-6665",
            "fax_number": "800-883-7015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "ALICIA",
        "middle_name": "CARMEN",
        "credential": "MS, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11233",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Haines City, FL
• Providers in Haines City, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.