Provider Demographics
NPI:1568250660
Name:BESCAK, OLIVIA ANNE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANNE
Last Name:BESCAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 LARK BUNTING AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-6533
Mailing Address - Country:US
Mailing Address - Phone:410-603-9819
Mailing Address - Fax:
Practice Address - Street 1:4115 BOARDWALK DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5945
Practice Address - Country:US
Practice Address - Phone:970-493-4580
Practice Address - Fax:970-797-2859
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health