Active NPI
Jean L Olson, LCSW BCD
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1396773149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- NC000340
- Practice address
- 4900 Waters Edge Dr
Suite 125
Raleigh, NC 27606 - Phone
- (919) 859-5206
- NPI assigned
- Jun 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | NC000340 | NC | Primary |
Addresses
Primary practice location
4900 Waters Edge Dr
Suite 125
Raleigh, NC 27606
Mailing address
4900 Waters Edge Dr
Suite 125
Raleigh, NC 27606
Phone (919) 859-5206
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036996 | Other | VALUE OPTIONS | |
| 11339428 | Other | CAQH PROVIDER | |
| 6267363 | Other | UBH | |
| 640S2 | Other | BCBS | |
| 10S0726 | Other | NC | CIGNA |
| 19082 | Other | MAGELLAN |
Other names 1
- Jean L P Olson
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC000340 | NC | MD | Clinical Social Worker |
| 340 | NC | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396773149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 WATERS EDGE DR",
"address_2": "SUITE 125",
"city": "RALEIGH",
"state": "NC",
"postal_code": "27606",
"telephone_number": "919-859-5206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 WATERS EDGE DR",
"address_2": "SUITE 125",
"city": "RALEIGH",
"state": "NC",
"postal_code": "27606",
"telephone_number": "919-859-5206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "JEAN",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LCSW BCD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "NC000340",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "036996",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PROVIDER",
"identifier": "11339428",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "6267363",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "640S2",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "10S0726",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "19082",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JEAN",
"last_name": "OLSON",
"middle_name": "L P",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.