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Organization
MIND LODGE
Active
Organization
MIND LODGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA OLSON LCPC (OWNER AND CLINICAL THERAPIST)
(815) 200-1099
Entity
Organization
Contact information
Practice address
24014 W RENWICK RD STE 105-5, PLAINFIELD, IL 60544-8708
(815) 200-1099
Mailing address
13855 S PETERSBURG DR, PLAINFIELD, IL 60544-7078
(815) 200-1099
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/08/2024
Last updated
11/07/2025
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