Individual provider Active NPI

Monica Jean Olsen, LMFT, LISAC

  • Addiction (Substance Use Disorder) Counselor
  • Eugene, OR
National Provider Identifier
1174619704
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1307 Lincoln St
Eugene, OR 97401-3978
Phone
(541) 636-0828
Fax
(458) 205-8376
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1307 Lincoln St
Eugene, OR 97401-3978

Mailing address

1307 Lincoln St
Eugene, OR 97401-3978
Phone (541) 636-0828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240823003943 OR Practitioner - Marriage and Family Therapist 9537608336 Practice locations: Eugene, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1174619704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 LINCOLN ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013978",
            "telephone_number": "541-636-0828",
            "fax_number": "458-205-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 LINCOLN ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013978",
            "telephone_number": "541-636-0828",
            "fax_number": "458-205-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "MONICA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LMFT, LISAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.