Provider Demographics
NPI:1205007192
Name:OLSEN, CINDY NMN (MS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:NMN
Last Name:OLSEN
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:OLSEN
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:114 GREAT RIVER RD
Mailing Address - Street 2:P.O. BOX 550
Mailing Address - City:GUTTENBERG
Mailing Address - State:IA
Mailing Address - Zip Code:52052-9437
Mailing Address - Country:US
Mailing Address - Phone:563-419-8374
Mailing Address - Fax:
Practice Address - Street 1:222 S RIVER PARK DR
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:IA
Practice Address - Zip Code:52052-7721
Practice Address - Country:US
Practice Address - Phone:563-419-8374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00455101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health