Provider Demographics
NPI:1558681262
Name:OLSON, GEORGE C (MA, LPC)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:C
Last Name:OLSON
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 COMMERCIAL ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5207
Mailing Address - Country:US
Mailing Address - Phone:503-949-5941
Mailing Address - Fax:
Practice Address - Street 1:2001 COMMERCIAL ST SE STE 200
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5207
Practice Address - Country:US
Practice Address - Phone:503-949-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2483101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional