Individual
MICHELLE M OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2600 OAKLAND AVE, ELKHART, IN 46517-1533
(574) 533-1234
(574) 537-2652
Mailing address
PO BOX 809, GOSHEN, IN 46527-0809
(574) 533-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000831A
IN
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
34006638A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200264420
—
IN
Enumeration date
02/05/2008
Last updated
06/13/2013
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