Healthcare Provider Details

I. General information

NPI: 1336219898
Provider Name (Legal Business Name): MICHAEL DAVID OHLSEN LSCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N MUR LEN RD SUITE 102
OLATHE KS
66062-1794
US

IV. Provider business mailing address

801 N MUR LEN RD STE 102
OLATHE KS
66062-1794
US

V. Phone/Fax

Practice location:
  • Phone: 785-764-0939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2462
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: