Provider Demographics
NPI:1871951848
Name:OLIVA, HEIDI (LIMHP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:OLIVA
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MARIE
Other - Last Name:STURDY OLIVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LIMHP
Mailing Address - Street 1:1716 OTOE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-4657
Mailing Address - Country:US
Mailing Address - Phone:312-502-5899
Mailing Address - Fax:
Practice Address - Street 1:1716 OTOE ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-4657
Practice Address - Country:US
Practice Address - Phone:312-502-5899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009369101YP2500X
NE2193101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL13679592OtherCOMMERCIAL INSURANCE