Provider Demographics
NPI:1023271814
Name:OLIVE, RANDEE LYNN (LSCSW)
Entity type:Individual
Prefix:MRS
First Name:RANDEE
Middle Name:LYNN
Last Name:OLIVE
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2521
Mailing Address - Country:US
Mailing Address - Phone:785-635-3183
Mailing Address - Fax:
Practice Address - Street 1:1900 HOLMES RD
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2521
Practice Address - Country:US
Practice Address - Phone:785-635-3183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS39421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical