Provider Demographics
NPI:1326234576
Name:OLSON, SHANNON LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:LYNN
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 1:435 SELKIRK DR
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-2745
Mailing Address - Country:US
Mailing Address - Phone:847-912-7662
Mailing Address - Fax:
Practice Address - Street 1:435 SELKIRK DR
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-2745
Practice Address - Country:US
Practice Address - Phone:847-912-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist