Provider Demographics
NPI:1295852648
Name:OLSON, KIMBER RAYE (LCSW, BCD)
Entity Type:Individual
Prefix:MRS
First Name:KIMBER
Middle Name:RAYE
Last Name:OLSON
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 H ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3446
Mailing Address - Country:US
Mailing Address - Phone:907-868-3181
Mailing Address - Fax:907-868-3181
Practice Address - Street 1:711 H ST
Practice Address - Street 2:SUITE 400
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3446
Practice Address - Country:US
Practice Address - Phone:907-868-3181
Practice Address - Fax:907-868-3181
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical