Healthcare Provider Details

I. General information

NPI: 1689721193
Provider Name (Legal Business Name): ANGELA OLSON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA SUE FLINTOFT M.A.

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24014 W RENWICK RD STE 105-5
PLAINFIELD IL
60544-8708
US

IV. Provider business mailing address

13855 S PETERSBURG DR
PLAINFIELD IL
60544-7078
US

V. Phone/Fax

Practice location:
  • Phone: 815-200-1099
  • Fax:
Mailing address:
  • Phone: 815-200-1130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180008051
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180008051
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: