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General NPI Number Information
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NPI Number | 1235890880
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Entity Type | Individual
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Provider Name | ROBERT OLSEN LMHC
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Gender | Male
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 4901 CENTER ST
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City | TACOMA
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State | WA
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Zip | 98409-2363
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Country | US
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Telephone | 253-355-6619
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Fax |
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Provider Business Mailing Address
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Address Line | 1909 WILLOW LN W
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City | TACOMA
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State | WA
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Zip | 98466-3631
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Country | US
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Telephone | 253-355-6619
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH60174444
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LH60174444
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LH60174444
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60174444
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License Number State | WA
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