MEDICARE: ZSANNETTE MICHELLE OLSON

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
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PRC15342	OTHER	DC	LPC LICENSE
2	0701007254	OTHER	VA	LPC LICENSE
3	4438	OTHER	OK	LPC LICENSE

General Provider Information

NPI Number	:	1649441916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZSANNETTE MICHELLE OLSON

Provider Business Mailing Address
First Line	:	24811 E 98TH ST S
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74014-3468
Country	:	US
Telephone Number	:	918-810-9867
Fax Number	:

Provider Business Practice Location Address
First Line	:	6987 FOREPOND CT
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-7416
Country	:	US
Telephone Number	:	918-810-9867
Fax Number	:

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

Provider Enumeration Date	:	03/14/2008
Last Update Date	:	04/14/2026

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