Individual provider Active NPI

Hallie Lauren Olson, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1205104494
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20738 Issued in MN
Practice address
525 Portland Ave # Mc963
Minneapolis, MN 55415-1533
Phone
(612) 348-5553
Fax
(612) 677-6248
NPI assigned
Dec 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20738 MN Primary

Addresses

Primary practice location

525 Portland Ave # Mc963
Minneapolis, MN 55415-1533

Mailing address

525 Portland Ave # Mc963
Minneapolis, MN 55415-1533
Phone (612) 348-5553

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
I20191008002819 MN Practitioner - Clinical Social Worker 7416288378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

1009 E 14TH St
Minneapolis, MN 55404-1314
Phone (612) 348-5553

1010 Currie Ave
Minneapolis, MN 55403-1309
Phone (612) 348-5553

2740 1St Ave S
Minneapolis, MN 55408-1611
Phone (612) 348-5553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County CurrentSince Sep 15, 2019 Accepting new patients
Hennepin County Clinical Current Accepting new patients
Hennepin County CurrentSince Sep 15, 2019 Accepting new patients

Locations

525 Portland Ave
Minneapolis, MN 55415
Phone (612) 348-8824

525 Portland Ave
#963
Minneapolis, MN 55415
Phone (612) 348-2233

Organizations & group practices 3

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": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1205104494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-348-5553",
            "fax_number": "612-677-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-348-5553",
            "fax_number": "612-677-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "HALLIE",
        "middle_name": "LAUREN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.