MEDICARE: SYDNEY ANNE OLSEN MA., RMHCI

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
1	101YM0800X	Mental Health Counselor	IMH25440	FL

General Provider Information

NPI Number	:	1619831286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY ANNE OLSEN MA., RMHCI

Provider Business Mailing Address
First Line	:	7901 4TH ST N STE 300
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4399
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 W SABAL PALM PL STE 200
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-3621
Country	:	US
Telephone Number	:	407-283-7905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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