Active NPI
Benjamin K Olson, MA, LPC, QMHP
- Mental Health Counselor
- Provo, UT
National Provider Identifier
1306356050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14295646-6004
- Practice address
- 1869 N 1120 W
Provo, UT 84604-1180 - Phone
- (503) 884-7422
- NPI assigned
- Oct 9, 2017
- Last updated
- Sep 29, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102088 | TX | MD | Professional Counselor |
| LPC-2022 | WY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Salem Pastoral Counseling Center | Mental Health | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.