Doctor Name: | CLAIRE OLSEN |
NPI Number: | 1245607944 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 1890 |
Business Practice Address: | 12 Colmar Ave Lake Grove, NY - 117552711 |
Business Phone Number: | 6314678788 |
Business Fax Number: | 6314678843 |
Mailing Address: | 12 Colmar Ave, LAKE GROVE |
State: | NY |
Postal Code: | 117552711 |
Phone Number: | 6314678788 |
Fax Number: | 6314678843 |
NPI Enumeration Date: | 08/28/2015 |
NPI Last Update Date: | 08/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1890 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |