Individual provider Active NPI

Corissa Johanna Olson, LMHC

  • Mental Health Counselor
  • Bremerton, WA
National Provider Identifier
1366828584
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
61382668 Issued in WA
Practice address
5610 Kitsap Way Ste 320
Bremerton, WA 98312-2266
Phone
(360) 792-2020
NPI assigned
Aug 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 61382668 WA Primary

Addresses

Primary practice location

5610 Kitsap Way Ste 320
Bremerton, WA 98312-2266

Mailing address

5610 Kitsap Way Ste 320
Bremerton, WA 98312-2266
Phone (360) 792-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61382668WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Community Services of Western Washington CurrentSince Feb 8, 2023 Accepting new patients

Locations

5610 Kitsap Way
Ste 320
Bremerton, WA 98312
Phone (360) 792-2020

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": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1366828584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 KITSAP WAY STE 320",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983122266",
            "telephone_number": "360-792-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 KITSAP WAY STE 320",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983122266",
            "telephone_number": "360-792-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CORISSA",
        "middle_name": "JOHANNA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61382668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.