Provider Demographics
NPI:1346588779
Name:OLSON, TAMARA DAWN (LMHP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:DAWN
Last Name:OLSON
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20275 HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-3962
Mailing Address - Country:US
Mailing Address - Phone:402-933-5700
Mailing Address - Fax:
Practice Address - Street 1:20275 HONEYSUCKLE DR
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3962
Practice Address - Country:US
Practice Address - Phone:402-933-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1845101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025073300Medicaid