Healthcare Provider Details

I. General information

NPI: 1689141616
Provider Name (Legal Business Name): STEPHANIE OLSON MA, LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2128 MIDLANDS CT STE 107
SYCAMORE IL
60178-3199
US

IV. Provider business mailing address

2128 MIDLANDS CT STE 107
SYCAMORE IL
60178-3199
US

V. Phone/Fax

Practice location:
  • Phone: 815-981-6236
  • Fax:
Mailing address:
  • Phone: 815-981-6236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.015871
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: