Provider Demographics
NPI:1568151496
Name:OLLEARIS COUNSELING LLC
Entity Type:Organization
Organization Name:OLLEARIS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLLEARIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:219-407-2911
Mailing Address - Street 1:8763 FOREST GLEN CT
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-8795
Mailing Address - Country:US
Mailing Address - Phone:708-624-8863
Mailing Address - Fax:
Practice Address - Street 1:1544 45TH ST
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3868
Practice Address - Country:US
Practice Address - Phone:219-407-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1518367135OtherKATHLEEN M OLLEARIS