Jaime Tavonia Olidge, LPC-A

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

88323 Issued in TX

Practice address

2911 A W Grimes Blvd Ste 330
Pflugerville, TX 78660-1979

Phone

(617) 379-0496

NPI assigned

Mar 3, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676073600000",
    "number": "1699098723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 A W GRIMES BLVD STE 330",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786601979",
            "telephone_number": "617-379-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 A W GRIMES BLVD STE 330",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786601979",
            "telephone_number": "617-379-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIDGE",
        "first_name": "JAIME",
        "middle_name": "TAVONIA",
        "name_prefix": "Ms.",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-03",
        "last_updated": "2023-02-11",
        "certification_date": "2023-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "88323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Oconnor
• Sijuwola Ode, RN
• Shanbria Darshaey Oglesby, LPC
• Sabainah Ogunrinade
• Genesis Nkechi Okorocha
• Madison Joy Olney, MS, CCC-SLP
• Shannon Alisa Olson
• Yetunde Omolara Olusanya, M.D.
• Faisal Omer
• Michael Omirin

• Professional Counselor in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.