Provider Demographics
NPI:1245770536
Name:OLIVER BEHAVIORAL CONSULTANTS LLC
Entity type:Organization
Organization Name:OLIVER BEHAVIORAL CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WALESHKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-459-7493
Mailing Address - Street 1:550 THORNTON PKWY UNIT 234
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-2167
Mailing Address - Country:US
Mailing Address - Phone:720-459-7493
Mailing Address - Fax:
Practice Address - Street 1:323 W MAIN ST # 101
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5966
Practice Address - Country:US
Practice Address - Phone:204-597-4937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OLIVER BEHAVIORAL CONSULTANTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-06
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04155173Medicaid