Provider Demographics
NPI:1477272912
Name:JILLIAN OLSON COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:JILLIAN OLSON COUNSELING SERVICES LLC
Other - Org Name:JILLIAN OLSON
Other - Org Type:Other Name
Authorized Official - Title/Position:INDEPENDENT MENTAL HEALTH PRACITION
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LDAC
Authorized Official - Phone:757-709-1437
Mailing Address - Street 1:1408 N 113TH PLZ
Mailing Address - Street 2:APT 6423
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5861
Mailing Address - Country:US
Mailing Address - Phone:757-709-1437
Mailing Address - Fax:
Practice Address - Street 1:1408 N 113TH PLZ
Practice Address - Street 2:APT 6423
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-5861
Practice Address - Country:US
Practice Address - Phone:757-709-1437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2023-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10027432501Medicaid