Provider Demographics
NPI:1699465880
Name:ALBERY, OLIVIA JEAN
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:JEAN
Last Name:ALBERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6870 W 91ST CT APT 8303
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-4885
Mailing Address - Country:US
Mailing Address - Phone:303-437-9856
Mailing Address - Fax:
Practice Address - Street 1:2620 S PARKER RD STE 18580014
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1608
Practice Address - Country:US
Practice Address - Phone:720-347-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO390200000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program