MEDICARE: MR. HOWARD OLSEN LPC, LMSW, LM

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	101YP2500X	Professional Counselor	11962	TX
2	1041C0700X	Clinical Social Worker	21598	TX

General Provider Information

NPI Number	:	1275519688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HOWARD OLSEN LPC, LMSW, LM

Provider Business Mailing Address
First Line	:	PO BOX 48675
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76148-0675
Country	:	US
Telephone Number	:	817-846-9718
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 N BEACH ST
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76137-3221
Country	:	US
Telephone Number	:	817-846-9718
Fax Number	:

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	09/11/2025

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