# CHAMPION STATE OF MIND PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033578331
- **Authorized official:** MRS. AMANDA OLSON LMHC, NCC (OWNER)
- **Authorized official phone:** (800) 592-0180

## Contact information

- **Practice address:** 508 W CENTRAL AVE, STE B, ESTHERVILLE, IA 51334-1834
- **Practice address phone:** (800) 592-0180
- **Practice address fax:** (712) 566-5229
- **Mailing address:** PO BOX 36, ESTHERVILLE, IA 51334-0036
- **Mailing address phone:** (800) 592-0180
- **Mailing address fax:** (712) 566-5229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 001653 | IA | Yes |

## Other

- **Enumeration date:** 02/15/2016
- **Last updated:** 09/11/2018