MEDICARE: NATHAN OLSON LCSW, QMHP, CADC III

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	101YM0800X	Mental Health Counselor	19-QMHPC-00526	OR
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	104100000X	Social Worker	L30038	OR
4	101YM0800X	Mental Health Counselor	QMHP	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942663968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN OLSON LCSW, QMHP, CADC III

Provider Business Mailing Address
First Line	:	315 CHERRY WOOD
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-6629
Country	:	US
Telephone Number	:	541-951-8168
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 CHERRY WOOD
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-6629
Country	:	US
Telephone Number	:	541-951-8168
Fax Number	:

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

Provider Enumeration Date	:	03/29/2016
Last Update Date	:	11/19/2025

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