Provider Demographics
NPI:1215682786
Name:KALINICH, OLIVIA (LMHC)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:KALINICH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5907 JFK BLVD E
Mailing Address - Street 2:APT A3
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093
Mailing Address - Country:US
Mailing Address - Phone:201-590-5628
Mailing Address - Fax:
Practice Address - Street 1:140 W 79TH ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6423
Practice Address - Country:US
Practice Address - Phone:212-877-7929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011329101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health