Provider Demographics
NPI:1902525686
Name:ACREE, OLIVIA RUTH (MA, NBCC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:RUTH
Last Name:ACREE
Suffix:
Gender:F
Credentials:MA, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4581 LAWYERS RD
Mailing Address - Street 2:
Mailing Address - City:EVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24550-4031
Mailing Address - Country:US
Mailing Address - Phone:440-635-6254
Mailing Address - Fax:
Practice Address - Street 1:112 CANDLEWOOD CT
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2653
Practice Address - Country:US
Practice Address - Phone:424-501-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014195101YM0800X, 101YP2500X
VA0730000579106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty