Provider Demographics
NPI:1790471142
Name:OLSON, JESSICA L (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:OLSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:GLISSENDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3701 W 49TH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4209
Mailing Address - Country:US
Mailing Address - Phone:605-777-0075
Mailing Address - Fax:888-977-2561
Practice Address - Street 1:3701 W 49TH ST STE 108
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-4209
Practice Address - Country:US
Practice Address - Phone:605-777-0075
Practice Address - Fax:888-977-2561
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC20715101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health