Provider Demographics
NPI:1982767729
Name:FLYNN, OLIVIA SEIBERT (LPC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:SEIBERT
Last Name:FLYNN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 N LOCUST ST APT 5
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3050
Mailing Address - Country:US
Mailing Address - Phone:940-566-3285
Mailing Address - Fax:940-566-3290
Practice Address - Street 1:1405 N LOCUST ST APT 5
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3050
Practice Address - Country:US
Practice Address - Phone:940-566-3285
Practice Address - Fax:940-566-3290
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10073101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional