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NPI Code Detail

MEDICARE: SASHA OLSSON LCSW

MEDICARE: SASHA OLSSON 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 WorkerL8060OR
21041C0700XClinical Social Worker783AK
3171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1962692764
Entity Type Code : Individual
Provider Name (Legal Business Name) : SASHA OLSSON LCSW
Provider Business Mailing Address
First Line : 3949 SOUTH 6TH STREET
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97603
Country : US
Telephone Number : 541-882-1487
Fax Number : 541-851-3983
Provider Business Practice Location Address
First Line : 6000 NEW WAY
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-9382
Country : US
Telephone Number : 541-884-1841
Fax Number : 907-729-4235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2007
Last Update Date : 05/04/2023

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