Healthcare Provider Details

I. General information

NPI: 1235563313
Provider Name (Legal Business Name): MONICA LYNNE OLSON MS, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 12/31/2021
Certification Date: 07/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MAIN ST S STE 311
MINOT ND
58701-3956
US

IV. Provider business mailing address

315 MAIN ST S STE 311
MINOT ND
58701-3956
US

V. Phone/Fax

Practice location:
  • Phone: 701-248-8315
  • Fax: 701-205-4593
Mailing address:
  • Phone: 701-248-8315
  • Fax: 701-205-4593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1002-4-1-426
License Number StateND

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: