Individual provider Active NPI

Janice M Olson, LPC

  • Mental Health Counselor
  • Rock Hill, SC
National Provider Identifier
1285782722
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC4792 Issued in SC
Practice address
2025 Ebenezer Rd
Suite C
Rock Hill, SC 29732-1062
Phone
(803) 448-7079
Fax
(803) 328-0336
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC4792 SC Primary

Addresses

Primary practice location

2025 Ebenezer Rd
Suite C
Rock Hill, SC 29732-1062

Mailing address

2025 Ebenezer Rd
Suite C
Rock Hill, SC 29732-1062
Phone (803) 448-7079

Other identifiers 1

IdentifierTypeStateIssuer
PC1178MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240203000135 SC Practitioner - Mental Health Counselor 1850734187 Practice locations: Rock Hill, SC

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Rock Hill, SC 29732
Phone (803) 448-7079

2025 Ebenezer Rd C
Rock Hill, SC 29732-1069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC4792SCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1285782722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 EBENEZER RD",
            "address_2": "SUITE C",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321062",
            "telephone_number": "803-448-7079",
            "fax_number": "803-328-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 EBENEZER RD",
            "address_2": "SUITE C",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321062",
            "telephone_number": "803-448-7079",
            "fax_number": "803-328-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JANICE",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "PC4792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1178",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.