Provider Demographics
NPI:1164569497
Name:OLSON, AMY AUTEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:AUTEN
Last Name:OLSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:KRISTINE
Other - Last Name:AUTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1169 OAK HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2634
Mailing Address - Country:US
Mailing Address - Phone:865-607-8566
Mailing Address - Fax:865-483-6697
Practice Address - Street 1:240 W TYRONE RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6517
Practice Address - Country:US
Practice Address - Phone:865-481-6170
Practice Address - Fax:865-483-6697
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical