Thomas Jacobus Olson, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301011436 Issued in MI

Practice address

720 W Wackerly St
Suite 4
Midland, MI 48640-2769

Phone

(989) 832-2165

Fax

(989) 839-4376

NPI assigned

Apr 11, 2007

Sex

Male

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 MI

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

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Partners in Change Psychological and Community Services, PLCGroup PAC ID 7719050814, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Partners in Change: Psychological & Community Services, PLC

  • Psychologist
  • Midland, MI
  • NPI 1093984817
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1467675116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3785 BAY RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032433",
            "telephone_number": "989-791-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W WACKERLY ST",
            "address_2": "SUITE 4",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402769",
            "telephone_number": "989-832-2165",
            "fax_number": "989-839-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "THOMAS",
        "middle_name": "JACOBUS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301011436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Olen
• Thomas A Olen, D.O.
• Briar Oliver
• Julie Olney
• Sarah Olson, PHARM.D
• David Olvera
• Elizabeth Ann Omalley, P.T.
• Ragina Ordiway
• Hernando Ornelas
• Sydney L Orokunle, MD

• Psychologist in Midland, MI
• Providers in Midland, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.