Nicholas Olsen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8919 Issued in WI

Practice address

6121 Green Bay Rd Ste 200
Kenosha, WI 53142-2931

Phone

(262) 674-3718

NPI assigned

Dec 1, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advance Clinical ServicesGroup PAC ID 4486156874, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advance Clinical Services

  • Clinical Social Worker
  • Kenosha, WI
  • NPI 1124791595
  Medicare reassignment Care Compare group NPD Authorized official
• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment NPD
• Genesis Counseling Services LTD.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Janesville, WI
  • NPI 1730273483
  Medicare reassignment NPD

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1104223510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 GREEN BAY RD STE 200",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422931",
            "telephone_number": "262-674-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 GREEN BAY RD STE 200",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422931",
            "telephone_number": "262-674-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "NICHOLAS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-01",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Nkemjika Okeke, DDS
• Abigail Jean Olcott, RD
• Kimberly Ann Oleksak, MSCC, LPC
• Jeanne E Olsen, PA-C
• Melissa M Olsen, LCPC
• Shae Olsen, LCSW
• Jordan Olson
• Joseph J Olszewski, MS LAT CSCS
• Kathryn A Omelina, NP
• Sosamma M Oommen

• Clinical Social Worker in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.