Provider Demographics
NPI:1225802267
Name:OLIVER, TAMIKA (LPC)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6176 NEWTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-5928
Mailing Address - Country:US
Mailing Address - Phone:267-616-1024
Mailing Address - Fax:
Practice Address - Street 1:6176 NEWTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-5928
Practice Address - Country:US
Practice Address - Phone:267-616-1024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health