Provider Demographics
NPI:1326069808
Name:OLAFSSON, MARIA C (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:OLAFSSON
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 1:20440 BARTLETT DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-1718
Mailing Address - Country:US
Mailing Address - Phone:262-993-1442
Mailing Address - Fax:
Practice Address - Street 1:2511 N 124TH ST STE 106
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4684
Practice Address - Country:US
Practice Address - Phone:262-641-4347
Practice Address - Fax:262-641-4350
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI76771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1693744Medicare ID - Type UnspecifiedLCSW