Provider Demographics
NPI:1558540112
Name:OLJA HAGLUND, LMSW, LLC
Entity Type:Organization
Organization Name:OLJA HAGLUND, LMSW, LLC
Other - Org Name:OLJA HAGLUND, LMSW,LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MASTER'S OF SOCIAL WORK
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLJA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAGLUND
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-712-6080
Mailing Address - Street 1:110 WEST GREENVILLE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-2140
Mailing Address - Country:US
Mailing Address - Phone:616-712-6080
Mailing Address - Fax:616-712-6088
Practice Address - Street 1:110 WEST GREENVILLE DRIVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-2140
Practice Address - Country:US
Practice Address - Phone:616-712-6080
Practice Address - Fax:616-712-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010872141041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty