Individual provider Active NPI

James Olson

  • Marriage & Family Therapist
  • St Louis Park, MN
National Provider Identifier
1306420617
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
5407 Excelsior Blvd Ste B
St Louis Park, MN 55416-2932
Phone
(612) 787-2832
NPI assigned
May 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

5407 Excelsior Blvd Ste B
St Louis Park, MN 55416-2932

Mailing address

5407 Excelsior Blvd Ste B
St Louis Park, MN 55416-2932
Phone (612) 787-2832

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
I20260211001363 MN Practitioner - Mental Health Counselor 3072092899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6465 Wayzata Blvd
Suite 710
St Louis Park, MN 55426-1733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5029MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
West End Therapy Clinic LLC Marriage & Family Therapist CurrentSince Jan 1, 2026 Accepting new patients

Locations

6465 Wayzata Blvd
Ste 710
St Louis Park, MN 55426
Phone (612) 735-8002

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1306420617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 EXCELSIOR BLVD STE B",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162932",
            "telephone_number": "612-787-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5407 EXCELSIOR BLVD STE B",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162932",
            "telephone_number": "612-787-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.