Provider Demographics
NPI:1891030805
Name:OLSON, JANICE LARAYNE (LPC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LARAYNE
Last Name:OLSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5833 PECAN ST
Mailing Address - Street 2:P.O. BOX 723
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-7093
Mailing Address - Country:US
Mailing Address - Phone:651-277-4283
Mailing Address - Fax:651-277-4284
Practice Address - Street 1:5833 PECAN ST
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MN
Practice Address - Zip Code:55056-7093
Practice Address - Country:US
Practice Address - Phone:651-277-4283
Practice Address - Fax:651-277-4284
Is Sole Proprietor?:No
Enumeration Date:2012-12-02
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional