Provider Demographics
NPI:1891472874
Name:OLSEN, ANGELA (LAPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:OLSEN
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAPC
Mailing Address - Street 1:407 CHERRYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-8890
Mailing Address - Country:US
Mailing Address - Phone:720-465-4318
Mailing Address - Fax:
Practice Address - Street 1:1800 E INTERSTATE AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1399
Practice Address - Country:US
Practice Address - Phone:701-323-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1303-6-1-23A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor