Provider Demographics
NPI:1669085114
Name:OLSEN, KRISTIN MARIE (LMSW-C)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:OLSEN
Suffix:
Gender:
Credentials:LMSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 PYLE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49802-4456
Mailing Address - Country:US
Mailing Address - Phone:906-779-0551
Mailing Address - Fax:
Practice Address - Street 1:703 N 2ND AVE
Practice Address - Street 2:
Practice Address - City:IRON RIVER
Practice Address - State:MI
Practice Address - Zip Code:49935-1451
Practice Address - Country:US
Practice Address - Phone:906-265-5126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011171691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical