Provider Demographics
NPI:1750630802
Name:OLSON, CATHLEEN (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:CATHLEEN
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 17TH ST STE T
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5687
Mailing Address - Country:US
Mailing Address - Phone:772-228-1165
Mailing Address - Fax:
Practice Address - Street 1:333 17TH ST STE T
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5687
Practice Address - Country:US
Practice Address - Phone:772-228-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2021-08-02
Deactivation Date:2021-05-11
Deactivation Code:
Reactivation Date:2021-06-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist