Provider Demographics
NPI:1215726096
Name:OLIVE-ALLISON, LORI S (LPC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:S
Last Name:OLIVE-ALLISON
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 10TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-3008
Mailing Address - Country:US
Mailing Address - Phone:256-565-8189
Mailing Address - Fax:
Practice Address - Street 1:1410 10TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-3008
Practice Address - Country:US
Practice Address - Phone:256-565-8189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014427101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health