Provider Demographics
NPI:1114022035
Name:OLSON, ROBERT D III (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:OLSON
Suffix:III
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 STEVENS DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-3360
Mailing Address - Country:US
Mailing Address - Phone:509-946-1430
Mailing Address - Fax:509-946-1432
Practice Address - Street 1:1124 STEVENS DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3360
Practice Address - Country:US
Practice Address - Phone:509-946-1430
Practice Address - Fax:509-946-1432
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health