Provider Demographics
NPI:1306419825
Name:OLIVEIRA, SUE LYNNE (LPC)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:LYNNE
Last Name:OLIVEIRA
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 1:43 CAITLIN CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1507
Mailing Address - Country:US
Mailing Address - Phone:646-823-7977
Mailing Address - Fax:
Practice Address - Street 1:43 CAITLIN CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:NJ
Practice Address - Zip Code:08823-1507
Practice Address - Country:US
Practice Address - Phone:646-823-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00725300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional