Individual provider Active NPI

Lisa Olsen, MSW, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1114516457
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34011207A Issued in IN
Practice address
8150 Madison Ave
Indianapolis, IN 46227-6076
Phone
(317) 887-3290
NPI assigned
Jan 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33009935A IN
Clinical Social Worker 1041C0700X 34011207A IN Primary

Addresses

Primary practice location

8150 Madison Ave
Indianapolis, IN 46227-6076

Mailing address

4117 Hazy LN
Greenwood, IN 46142-7495
Phone (812) 631-2572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240806001511 IN Practitioner - Clinical Social Worker 4688111867 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33009935AINMDSocial Worker
34011207AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adult and Child Mental Health Center Inc CurrentSince Jul 1, 2024 Accepting new patients
Adult and Child Mental Health Center Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

8404 Siear Ter
Ste 100
Indianapolis, IN 46227
Phone (877) 882-5122

8320 Madison Ave
Indianapolis, IN 46227
Phone (317) 881-7061

Interoperability endpoints

  • Direct secure messaging: lisa.olsen.p1@direct.adultandchild.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1114516457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 HAZY LN",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461427495",
            "telephone_number": "812-631-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276076",
            "telephone_number": "317-887-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "LISA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33009935A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34011207A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.