Provider Demographics
NPI:1043806094
Name:OLSON, CHRISTOPER STEVEN (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPER
Middle Name:STEVEN
Last Name:OLSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 E SARATOGA ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-2826
Mailing Address - Country:US
Mailing Address - Phone:248-672-7368
Mailing Address - Fax:
Practice Address - Street 1:295 ELM ST STE 5
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6344
Practice Address - Country:US
Practice Address - Phone:248-455-6161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011085131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical