Provider Demographics
NPI:1730926791
Name:COLE, OLIVIA ANNE (LPC)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANNE
Last Name:COLE
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 W STAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-6343
Mailing Address - Country:US
Mailing Address - Phone:361-433-7822
Mailing Address - Fax:
Practice Address - Street 1:302 W FORREST ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6409
Practice Address - Country:US
Practice Address - Phone:361-433-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021980101YM0800X
TX91171101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health