Provider Demographics
NPI:1740061704
Name:OLSON, SHANTELL (LPC)
Entity type:Individual
Prefix:
First Name:SHANTELL
Middle Name:
Last Name:OLSON
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOODS OF BOERNE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2882
Mailing Address - Country:US
Mailing Address - Phone:830-967-7422
Mailing Address - Fax:
Practice Address - Street 1:101 WOODS OF BOERNE BLVD STE 2
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2862
Practice Address - Country:US
Practice Address - Phone:803-967-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)