Provider Demographics
NPI:1114237997
Name:OLSON, KAREN L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:OLSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73950 ZIRCON CIR W
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2274
Mailing Address - Country:US
Mailing Address - Phone:626-533-0637
Mailing Address - Fax:760-818-8157
Practice Address - Street 1:74710 HIGHWAY 111 STE 102
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3820
Practice Address - Country:US
Practice Address - Phone:760-839-8199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA665151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1548442Medicaid