Provider Demographics
NPI:1215601083
Name:OLSON, KARLIE (CSW)
Entity Type:Individual
Prefix:
First Name:KARLIE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2297 KANSAS AVE SE STE 5
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-4287
Mailing Address - Country:US
Mailing Address - Phone:605-941-1509
Mailing Address - Fax:605-205-8962
Practice Address - Street 1:2297 KANSAS AVE SE STE 5
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-4287
Practice Address - Country:US
Practice Address - Phone:605-941-1509
Practice Address - Fax:605-205-8962
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD60431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6043OtherBOARD OF SOCIAL WORK EXAMINERS