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NPI Code Detail

MEDICARE: DEMI MARIE OLSTAD LPC

MEDICARE: DEMI MARIE OLSTAD LPC
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
1101YM0800XMental Health Counselor1137-6-15-21ND
2101YM0800XMental Health CounselorLPC-23179AZ

General Provider Information

NPI Number : 1831767136
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEMI MARIE OLSTAD LPC
Provider Business Mailing Address
First Line : 1535 N SCOTTSDALE RD APT 2152
Second Line :
City : TEMPE
State : AZ
Zip : 85288-1590
Country : US
Telephone Number : 701-840-3615
Fax Number :
Provider Business Practice Location Address
First Line : 1375 N SCOTTSDALE RD STE 200
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85257-3429
Country : US
Telephone Number : 480-877-9284
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2021
Last Update Date : 07/23/2024

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Directions to “ DEMI MARIE OLSTAD LPC” Practice Location

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