Provider Demographics
NPI:1144590571
Name:OLIN, ERIC CHARLES (LMHC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:CHARLES
Last Name:OLIN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N ORLANDO AVE STE 203A
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4403
Mailing Address - Country:US
Mailing Address - Phone:321-209-3359
Mailing Address - Fax:
Practice Address - Street 1:711 N ORLANDO AVE STE 203A
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4403
Practice Address - Country:US
Practice Address - Phone:321-209-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health