Provider Demographics
NPI:1225793300
Name:OLSON, ANNEMARIE K (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:K
Last Name:OLSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 IRWIN ST # 1110
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3943
Mailing Address - Country:US
Mailing Address - Phone:415-683-1441
Mailing Address - Fax:
Practice Address - Street 1:655 IRWIN ST # 1110
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3943
Practice Address - Country:US
Practice Address - Phone:415-683-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA279551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical