Provider Demographics
NPI:1174290449
Name:OLSEN, MADISON ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MADISON
Middle Name:ELIZABETH
Last Name:OLSEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:THORNWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10594-1355
Mailing Address - Country:US
Mailing Address - Phone:914-984-8447
Mailing Address - Fax:
Practice Address - Street 1:586 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:THORNWOOD
Practice Address - State:NY
Practice Address - Zip Code:10594-1355
Practice Address - Country:US
Practice Address - Phone:914-984-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024428-01103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist