Olliff, Charles Lee

Olliff, Charles Lee is an sole proprietor health care provider with primary practice located at 415 S 11Th St , Beaumont TX 77701-3834. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Olliff, Charles Lee can be contacted via phone (409) 813-1116.

Contact Information

Primary practice address
415 S 11Th St Beaumont TX 77701-3834
Phone: (409) 813-1116
Fax: (409) 813-1116
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 15662 Texas

Profile Details

NPI number 1477562056
LBN Legal business name Olliff, Charles Lee
Credentials M.ED.,LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2006
Last updated Jan 6th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477562056 NPPES
Texas MEDICAID 096045204

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