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NPI Code Detail

MEDICARE: MS. STELLA OLSON LCSW

MEDICARE: MS. STELLA 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
11041C0700XClinical Social Worker44SC05417200NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
144SC05417200OTHERLICENSE NUMBER

General Provider Information

NPI Number : 1811290778
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STELLA OLSON LCSW
Provider Business Mailing Address
First Line : 150 NEW PROVIDENCE RD
Second Line :
City : MOUNTAINSIDE
State : NJ
Zip : 07092-2590
Country : US
Telephone Number : 908-233-3720
Fax Number : 908-389-5654
Provider Business Practice Location Address
First Line : 500 WESTFIELD AVE
Second Line :
City : ELIZABETH
State : NJ
Zip : 07208-1642
Country : US
Telephone Number : 908-994-1500
Fax Number : 908-994-0035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2010
Last Update Date : 01/29/2020

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Directions to “ MS. STELLA OLSON LCSW” Practice Location

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