Provider Demographics
NPI:1821195124
Name:OLSEN, ANNE M (MSW, LMSW, ACSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:OLSEN
Suffix:
Gender:F
Credentials:MSW, LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 TUSCOLA
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6995
Mailing Address - Country:US
Mailing Address - Phone:989-895-0788
Mailing Address - Fax:
Practice Address - Street 1:114 TUSCOLA
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-6995
Practice Address - Country:US
Practice Address - Phone:989-895-0788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010605361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI042659OtherCIGNA
MI1014496OtherMCLAREN
MI042659OtherVALUE OPTIONS
MI0995531OtherHEALTHPLUS
MI1014496OtherMCLAREN