Provider Demographics
NPI:1447983879
Name:OLIVETT, MARIE EVELYN (LCSW, LAC)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:EVELYN
Last Name:OLIVETT
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16881 E BROWN PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-1924
Mailing Address - Country:US
Mailing Address - Phone:606-207-1406
Mailing Address - Fax:
Practice Address - Street 1:16881 E BROWN PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-1924
Practice Address - Country:US
Practice Address - Phone:606-207-1406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.001582101YA0400X
COCSW.099253761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)