Provider Demographics
NPI:1346046307
Name:OLVERA, DESTINY RENEE (LMHC)
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:RENEE
Last Name:OLVERA
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 S MESA HILLS DR APT 101
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5180
Mailing Address - Country:US
Mailing Address - Phone:505-559-3394
Mailing Address - Fax:
Practice Address - Street 1:945 S MESA HILLS DR APT 101
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5180
Practice Address - Country:US
Practice Address - Phone:505-559-3394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2025-0070101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health