Healthcare Provider Details

I. General information

NPI: 1336018431
Provider Name (Legal Business Name): OLSON COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 BOYSON RD NE APT 124
CEDAR RAPIDS IA
52402-7390
US

IV. Provider business mailing address

PO BOX 57054
JACKSONVILLE FL
32241-7054
US

V. Phone/Fax

Practice location:
  • Phone: 904-551-4286
  • Fax:
Mailing address:
  • Phone: 904-551-4286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: AMITY OLSON
Title or Position: CLINICAL SOCIAL WORKER/OWNER
Credential: LCSW
Phone: 904-551-4286