MEDICARE: ASHLEY NOEL OLSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	100760	CA
2	1041C0700X	Clinical Social Worker	20599	AZ

General Provider Information

NPI Number	:	1003486085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NOEL OLSON LCSW

Provider Business Mailing Address
First Line	:	1001 2ND ST STE 225
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94559-3030
Country	:	US
Telephone Number	:	855-427-2778
Fax Number	:	707-927-0069

Provider Business Practice Location Address
First Line	:	1001 2ND ST STE 225
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94559-3030
Country	:	US
Telephone Number	:	855-427-2778
Fax Number	:	707-927-0069

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	09/08/2022

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Directions to “ ASHLEY NOEL OLSON LCSW” Practice Location

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