Provider Demographics
NPI:1982199535
Name:PHILLIPS OLSON, KATHERINE MARIA (MSW, CSW-PIP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIA
Last Name:PHILLIPS OLSON
Suffix:
Gender:F
Credentials:MSW, CSW-PIP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIA
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 W ALGONQUIN ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-0264
Mailing Address - Country:US
Mailing Address - Phone:056-988-5537
Mailing Address - Fax:
Practice Address - Street 1:1201 W ALGONQUIN ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-0264
Practice Address - Country:US
Practice Address - Phone:605-988-5537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5162104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker