Provider Demographics
NPI:1063019248
Name:NICHOLAS A. OLEEN-JUNK, PH.D., PLLC
Entity Type:Organization
Organization Name:NICHOLAS A. OLEEN-JUNK, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:OLEEN-JUNK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-332-5100
Mailing Address - Street 1:216 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2431
Mailing Address - Country:US
Mailing Address - Phone:281-332-5100
Mailing Address - Fax:281-332-5155
Practice Address - Street 1:216 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2431
Practice Address - Country:US
Practice Address - Phone:281-332-5100
Practice Address - Fax:281-332-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty