Active NPI
Jennifer Duncan Olson, PH.D.
- Psychologist
- Syracuse, NY
National Provider Identifier
1063816858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 68 019482
- Practice address
- 650 S Terry Rd
Syracuse, NY 13219-3050 - Phone
- (315) 263-6391
- NPI assigned
- Oct 22, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 68 019482 | NY | Primary |
Addresses
Primary practice location
650 S Terry Rd
Syracuse, NY 13219-3050
Mailing address
650 S Terry Rd
Syracuse, NY 13219-3050
Phone (315) 263-6391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68 019482 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Onondaga County Department of Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Syracuse, NY
- NPI 1912179292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1063816858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 S TERRY RD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132193050",
"telephone_number": "315-263-6391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 S TERRY RD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132193050",
"telephone_number": "315-263-6391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNCAN OLSON",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-22",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "68 019482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.