Provider Demographics
NPI:1669696415
Name:OLSSON, KURT (LCSW)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:OLSSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 VIRGINIA PINE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23237-2203
Mailing Address - Country:US
Mailing Address - Phone:804-743-0727
Mailing Address - Fax:
Practice Address - Street 1:3201 CHERRY RIDGE ST STE C320
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4800
Practice Address - Country:US
Practice Address - Phone:210-541-1447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040068541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical