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NPI Code Detail

MEDICARE: JENNIFER KATHLEEN OLSTON LCSW

MEDICARE: JENNIFER KATHLEEN OLSTON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34004938AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000485293OTHERINANTHEM BCBS PROVIDER PIN

General Provider Information

NPI Number : 1568446441
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KATHLEEN OLSTON LCSW
Provider Business Mailing Address
First Line : 6626 E 75TH ST STE 500
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1525 N RITTER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-3026
Country : US
Telephone Number : 317-359-5467
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2005
Last Update Date : 03/10/2026

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