Provider Demographics
NPI:1144216904
Name:OLSON, PAULA L (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:L
Last Name:OLSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:MA
Mailing Address - Zip Code:01341-0616
Mailing Address - Country:US
Mailing Address - Phone:413-369-4903
Mailing Address - Fax:413-369-8086
Practice Address - Street 1:160 MAIN ST
Practice Address - Street 2:SUITE 14
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3137
Practice Address - Country:US
Practice Address - Phone:413-586-6471
Practice Address - Fax:413-369-8086
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1045241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical