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Organization
OLIVE BRANCH COUNSELING PLLC
Active
Organization
OLIVE BRANCH COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADYSEN MARIE OSTROWSKI LCPC (OWNER/MENTAL HEALTH THERAPIST)
(815) 307-4849
Entity
Organization
Contact information
Practice address
128 ELLSWORTH ST, CRYSTAL LAKE, IL 60014-4421
(815) 307-4849
Mailing address
128 ELLSWORTH ST, CRYSTAL LAKE, IL 60014-4421
(815) 307-4849
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180010920
LCPC/OWNER
IL
Enumeration date
09/13/2021
Last updated
09/13/2021
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