Individual provider Active NPI

Alan Olson, LPC LAMFT

  • Marriage & Family Therapist
  • Lakeville, MN
National Provider Identifier
1083703987
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LAMFT 1444 Issued in MN
Practice address
7580 160TH St W
Lakeville, MN 55044-8348
Phone
(952) 898-1133
Fax
(952) 435-6797
NPI assigned
Oct 11, 2006
Last updated
Oct 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC 0200 MN
Marriage & Family Therapist 106H00000X LAMFT 1444 MN Primary

Addresses

Primary practice location

7580 160TH St W
Lakeville, MN 55044-8348

Mailing address

7580 160TH St. W
Lakeville, MN 55044
Phone (952) 898-1133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213002268 MN Practitioner - Marriage and Family Therapist 5294178653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Life Development Resources PAGroup PAC ID 5890779847, 20 clinicians

Practice addresses (Care Compare)

7580 160TH St W
Lakeville, MN 55044-8348
Phone (952) 898-1133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC 0200MNMDProfessional Counselor
LAMFT 1444MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Development Resources, PA Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

7580 160th St W
Lakeville, MN 55044
Phone (952) 898-1133

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1083703987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 160TH ST. W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "55044",
            "telephone_number": "952-898-1133",
            "fax_number": "952-435-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 160TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448348",
            "telephone_number": "952-898-1133",
            "fax_number": "952-435-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "LPC LAMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "LPC 0200",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LAMFT 1444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.