Provider Demographics
NPI:1962961029
Name:OLEARY, JAMIE ELYSE (LPC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ELYSE
Last Name:OLEARY
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 1:21 ALBANS CT
Mailing Address - Street 2:
Mailing Address - City:BERNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19506-8357
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 ALBANS CT
Practice Address - Street 2:
Practice Address - City:BERNVILLE
Practice Address - State:PA
Practice Address - Zip Code:19506-8357
Practice Address - Country:US
Practice Address - Phone:215-760-6974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011051101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional