Tieryn M Olson, QMHP, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L6978 Issued in OR

Practice address

2421 Lancaster Dr NE
Salem, OR 97305-1220

Phone

(503) 588-5352

NPI assigned

Nov 7, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD (past)

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547251200000",
    "number": "1346594777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2462 WEMBLEY CT NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973041807",
            "telephone_number": "503-910-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051220",
            "telephone_number": "503-588-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "TIERYN",
        "middle_name": "M",
        "credential": "QMHP, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2019-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George C Olson, M.A., L.P.C.
• Heather Elaine Olson, LMS
• Jaime Ann Olson
• Mark Warren Olson, M.D.
• Sonya R Olson, CHW
• Vanessa Kristine Strom Olson, DDS
• Nels Enst Gerhard Olsson, BA, CADC-R, PSS
• Sarah B Oltman, PA-C
• Abayomi Moses Olusanu
• Olympic Place Retirement & Assisted Living Community LLC

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2019; 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.

Verify at the official NPI Registry.