Provider Demographics
NPI:1740296748
Name:OLSON, MARGARET M (LCSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:OLSON
Suffix:
Gender:F
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:PO BOX 994
Mailing Address - Street 2:350
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-0994
Mailing Address - Country:US
Mailing Address - Phone:262-284-8200
Mailing Address - Fax:262-284-8104
Practice Address - Street 1:3001 GREEN BAY ROAD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60014
Practice Address - Country:US
Practice Address - Phone:815-759-2306
Practice Address - Fax:815-759-1953
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71841231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40944900Medicaid
WI40944900Medicaid