Provider Demographics
NPI:1457552994
Name:OLSEN, VICTOR J (LMFT)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:J
Last Name:OLSEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PATMAR DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1514
Mailing Address - Country:US
Mailing Address - Phone:203-984-3195
Mailing Address - Fax:
Practice Address - Street 1:41 PATMAR DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1514
Practice Address - Country:US
Practice Address - Phone:203-984-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000660106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist