Individual provider Active NPI

Benjamin K Olson, MA, LPC, QMHP

  • Mental Health Counselor
  • Provo, UT
National Provider Identifier
1306356050
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
14295646-6004 Issued in UT
Practice address
1869 N 1120 W
Provo, UT 84604-1180
Phone
(503) 884-7422
NPI assigned
Oct 9, 2017
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 14295646-6004 UT Primary
Professional Counselor 101YP2500X 102088 TX
Professional Counselor 101YP2500X C8224 OR

Addresses

Primary practice location

1869 N 1120 W
Provo, UT 84604-1180

Mailing address

6310 Naaman Forest Blvd
Suite 1401
Garland, TX 75044
Phone (503) 884-7422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • 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
I20240610002734 OR Practitioner - Mental Health Counselor 1557803251 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
102088TXMDProfessional Counselor
LPC-2022WYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Pastoral Counseling Center Mental Health CurrentSince May 20, 2024 Accepting new patients

Locations

2001 Commercial St SE
Salem, OR 97302
Phone (503) 363-1500

2001 Commercial St SE
Ste 200
Salem, OR 97302
Phone (503) 370-8050

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1306356050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 NAAMAN FOREST BLVD",
            "address_2": "SUITE 1401",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75044",
            "telephone_number": "503-884-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1869 N 1120 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041180",
            "telephone_number": "503-884-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "BENJAMIN",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "MA, LPC, QMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-09",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "14295646-6004",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "102088",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C8224",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.