Provider Demographics
NPI:1467946475
Name:DEHAARTE, OLIVIA A
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:A
Last Name:DEHAARTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NW 170TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5510
Mailing Address - Country:US
Mailing Address - Phone:786-785-0585
Mailing Address - Fax:786-780-2145
Practice Address - Street 1:100 NW 170TH ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5510
Practice Address - Country:US
Practice Address - Phone:786-785-0585
Practice Address - Fax:786-780-2145
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)