Provider Demographics
NPI:1952640252
Name:OLSON, GENA ANN (LPC, LAC)
Entity Type:Individual
Prefix:MRS
First Name:GENA
Middle Name:ANN
Last Name:OLSON
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 EAST DOUGLAS AVE
Mailing Address - Street 2:2ND FLOOR - #629
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 ANDERSON AVE STE 104
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2809
Practice Address - Country:US
Practice Address - Phone:785-510-0097
Practice Address - Fax:844-318-2492
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS273101YA0400X
KS04138101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)