MR. JERRY LYNN OLSON LPC CADC III NPI 1699849992

NPI Information

NPI: 1699849992
Provider Name: MR. JERRY LYNN OLSON, LPC CADC III
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
252 SOUTH CENTRAL AVENUE
SUITE # 24
MARSHFIELD, WI
ZIP 54449
Phone: (715) 384-7884
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MR. Jerry Lynn Olson, LPC CADC III is an addiction (substance use disorder) counselor in Marshfield, WI. MR. Jerry Lynn Olson, LPC CADC III NPI is 1699849992. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

252 SOUTH CENTRAL AVENUE
SUITE # 24
MARSHFIELD, WI
ZIP 54449-241
Phone: (715) 384-7884
Fax: (715) 384-7881

The enumeration date for this NPI number is 11/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes
2	101YP2500X	Counselor	Professional	1802-125	WISCONSIN	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1802-125	OTHER	WISCONSIN	LPC
2	1063	OTHER	WISCONSIN	CADC III

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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