Healthcare Provider Details

I. General information

NPI: 1952520892
Provider Name (Legal Business Name): COLEEN OLSSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 ROUTE 228 STE 1104
CRANBERRY TOWNSHIP PA
16066-5307
US

IV. Provider business mailing address

1675 ROUTE 228 STE 1104
CRANBERRY TOWNSHIP PA
16066-5307
US

V. Phone/Fax

Practice location:
  • Phone: 724-544-1931
  • Fax:
Mailing address:
  • Phone: 724-544-1931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2203418
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW016668
License Number StatePA

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: