Provider Demographics
NPI:1245548015
Name:OLMSCHEID, DAVID MATTHEW (MS LMFT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MATTHEW
Last Name:OLMSCHEID
Suffix:
Gender:M
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 STEARNS WAY
Mailing Address - Street 2:SUITE #111
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303
Mailing Address - Country:US
Mailing Address - Phone:320-253-3540
Mailing Address - Fax:
Practice Address - Street 1:538 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-8663
Practice Address - Country:US
Practice Address - Phone:844-221-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist