Provider Demographics
NPI:1811261647
Name:CRAIG D. OLSON PSY.D. & ASSOCIATES, LLC
Entity type:Organization
Organization Name:CRAIG D. OLSON PSY.D. & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:937-436-5999
Mailing Address - Street 1:PO BOX 751371
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45475-1371
Mailing Address - Country:US
Mailing Address - Phone:937-436-5999
Mailing Address - Fax:937-435-5929
Practice Address - Street 1:7071 CORPORATE WAY
Practice Address - Street 2:SUITE 106
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459
Practice Address - Country:US
Practice Address - Phone:937-436-5999
Practice Address - Fax:937-530-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4487103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty