Provider Demographics
NPI:1295178473
Name:OLSON, JOSHUA JOHN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:JOHN
Last Name:OLSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7502 WESTWARD WAY
Mailing Address - Street 2:APT 203
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2050
Mailing Address - Country:US
Mailing Address - Phone:608-385-0677
Mailing Address - Fax:
Practice Address - Street 1:8025 EXCELSIOR DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1900
Practice Address - Country:US
Practice Address - Phone:608-663-6154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316-228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist