Provider Demographics
NPI:1629601240
Name:OLSEN, KATHRYN LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LOUISE
Last Name:OLSEN
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 1:1131 E BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73131-2004
Mailing Address - Country:US
Mailing Address - Phone:405-475-5505
Mailing Address - Fax:
Practice Address - Street 1:1131 E BRITTON RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-2004
Practice Address - Country:US
Practice Address - Phone:405-475-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OK21161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical