Provider Demographics
NPI:1790938934
Name:DENISE OLIN, INC.
Entity Type:Organization
Organization Name:DENISE OLIN, INC.
Other - Org Name:DENISE OLIN, PSY.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:530-888-8037
Mailing Address - Street 1:PO BOX 431
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05250-0431
Mailing Address - Country:US
Mailing Address - Phone:530-888-8037
Mailing Address - Fax:888-357-3255
Practice Address - Street 1:3938 ROUTE 7A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05250-4456
Practice Address - Country:US
Practice Address - Phone:530-888-8037
Practice Address - Fax:888-357-3255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CA20480251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL204800Medicare PIN