Provider Demographics
NPI:1235658378
Name:OLIVERIUS, DAVID (PLMH PLADC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:OLIVERIUS
Suffix:
Gender:M
Credentials:PLMH PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 S 24TH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1226
Mailing Address - Country:US
Mailing Address - Phone:402-342-7007
Mailing Address - Fax:402-591-5075
Practice Address - Street 1:11515 S 39TH ST STE 300
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-5206
Practice Address - Country:US
Practice Address - Phone:402-292-9105
Practice Address - Fax:402-591-5075
Is Sole Proprietor?:No
Enumeration Date:2017-09-10
Last Update Date:2017-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101YA0400X
NE11298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)