Provider Demographics
NPI:1891952396
Name:OLSON, CHAD (MS)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:OLSON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 W 1940 N
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4756
Mailing Address - Country:US
Mailing Address - Phone:435-216-2981
Mailing Address - Fax:
Practice Address - Street 1:1173 SO 250 WEST
Practice Address - Street 2:BLDG 1- SUITE 208
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-6747
Practice Address - Country:US
Practice Address - Phone:435-632-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6992931-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist