Provider Demographics
NPI:1285882191
Name:OLIVER, MONICA LYNETTE (LPC)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNETTE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 OLD UNION RD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3237
Mailing Address - Country:US
Mailing Address - Phone:936-433-2469
Mailing Address - Fax:936-238-3867
Practice Address - Street 1:602 S JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3121
Practice Address - Country:US
Practice Address - Phone:936-238-3868
Practice Address - Fax:936-238-3867
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64337101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health