Provider Demographics
NPI:1659979870
Name:OLSON, LISA DAWN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:DAWN
Last Name:OLSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 W MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4737
Mailing Address - Country:US
Mailing Address - Phone:509-499-5860
Mailing Address - Fax:
Practice Address - Street 1:327 W MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4737
Practice Address - Country:US
Practice Address - Phone:509-499-5860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60016807101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health