Provider Demographics
NPI:1275323750
Name:OLIVE LEAF COUNSELING CENTER PLLC
Entity type:Organization
Organization Name:OLIVE LEAF COUNSELING CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OLIVE LEAF COUNSELING CENTER, PLLC
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINDHAM, M.MFT LMFT
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGING MEMBER OF
Authorized Official - Phone:325-725-0810
Mailing Address - Street 1:PO BOX 551
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:TX
Mailing Address - Zip Code:79510-0551
Mailing Address - Country:US
Mailing Address - Phone:325-725-0810
Mailing Address - Fax:
Practice Address - Street 1:1500 INDUSTRIAL BLVD STE 305-B
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7969
Practice Address - Country:US
Practice Address - Phone:254-433-8869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty