Provider Demographics
NPI:1184296733
Name:OLSON, AMITY (LCSW)
Entity type:Individual
Prefix:
First Name:AMITY
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7236 FLYHAWK LN
Mailing Address - Street 2:
Mailing Address - City:SAUK CITY
Mailing Address - State:WI
Mailing Address - Zip Code:53583-9748
Mailing Address - Country:US
Mailing Address - Phone:920-277-8256
Mailing Address - Fax:
Practice Address - Street 1:7236 FLYHAWK LN
Practice Address - Street 2:
Practice Address - City:SAUK CITY
Practice Address - State:WI
Practice Address - Zip Code:53583-9748
Practice Address - Country:US
Practice Address - Phone:920-277-8256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical