Provider Demographics
NPI:1821750340
Name:OLIVER, LINSEY KATE (MS)
Entity Type:Individual
Prefix:
First Name:LINSEY
Middle Name:KATE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 N ASTOR ST LOWR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1505
Mailing Address - Country:US
Mailing Address - Phone:414-550-6443
Mailing Address - Fax:
Practice Address - Street 1:1709 N ASTOR ST LOWR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1505
Practice Address - Country:US
Practice Address - Phone:414-550-6443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5069-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health