Provider Demographics
NPI:1205083375
Name:OLCHEFSKE, BETH ADAIR (LP)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ADAIR
Last Name:OLCHEFSKE
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-4301
Mailing Address - Country:US
Mailing Address - Phone:507-383-6116
Mailing Address - Fax:507-377-1724
Practice Address - Street 1:668 MEADOW LN
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-4301
Practice Address - Country:US
Practice Address - Phone:507-383-6116
Practice Address - Fax:507-377-1724
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy