MEDICARE: JOSHUA OLSON PLMHP

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	12377	NE

General Provider Information

NPI Number	:	1982289567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA OLSON PLMHP

Provider Business Mailing Address
First Line	:	3311 N 93RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4727
Country	:	US
Telephone Number	:	308-534-4101
Fax Number	:

Provider Business Practice Location Address
First Line	:	3311 N 93RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4727
Country	:	US
Telephone Number	:	308-534-4101
Fax Number	:

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

Provider Enumeration Date	:	03/15/2021
Last Update Date	:	03/15/2021

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