Individual provider Active NPI

Jenifer Catherine Olson, LCSW

  • Clinical Social Worker
  • Eau Claire, WI
National Provider Identifier
1386287522
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8539-123 Issued in WI
Practice address
5468 Tower Dr
Eau Claire, WI 54703-8722
Phone
(715) 829-0602
NPI assigned
Oct 21, 2019
Last updated
Oct 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8539-123 WI Primary

Addresses

Primary practice location

5468 Tower Dr
Eau Claire, WI 54703-8722

Mailing address

5468 Tower Dr
Eau Claire, WI 54703-8722
Phone (715) 829-0602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20210517002249 WI Practitioner - Clinical Social Worker 7517376858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Healing Mental Health Center LLC Clinical CurrentSince Nov 30, 2022 Accepting new patients

Locations

1791 County Highway OO
Chippewa Falls, WI 54729
Phone (715) 797-2770

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": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1386287522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5468 TOWER DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547038722",
            "telephone_number": "715-829-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5468 TOWER DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547038722",
            "telephone_number": "715-829-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JENIFER",
        "middle_name": "CATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8539-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.