Provider Demographics
NPI:1497161368
Name:OLIVIER, TRAVIS MICHAEL (MED, NCC, LPC)
Entity Type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:MICHAEL
Last Name:OLIVIER
Suffix:
Gender:M
Credentials:MED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PAPWORTH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4923
Mailing Address - Country:US
Mailing Address - Phone:504-858-9075
Mailing Address - Fax:
Practice Address - Street 1:701 PAPWORTH AVE STE 201
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4923
Practice Address - Country:US
Practice Address - Phone:504-858-9075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5195101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor