Provider Demographics
NPI:1801402391
Name:FOADEY, OLIVIA KOCOEVI (LCSW)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:KOCOEVI
Last Name:FOADEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16428 AVENTURA AVE
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2579
Mailing Address - Country:US
Mailing Address - Phone:512-909-4810
Mailing Address - Fax:
Practice Address - Street 1:12151 W PARMER LN STE 202
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2171
Practice Address - Country:US
Practice Address - Phone:512-593-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-20
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX556861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical