Individual provider Active NPI

Karen Ann Olson, PH.D.

  • Clinical Psychologist
  • Iron Mountain, MI
National Provider Identifier
1487987269
Registry record updated Jul 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301006240 Issued in MI
Practice address
216 E Ludington St
Iron Mountain, MI 49801-2918
Phone
(906) 239-9918
NPI assigned
Sep 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301006240 MI Primary

Addresses

Primary practice location

216 E Ludington St
Iron Mountain, MI 49801-2918

Mailing address

823 6TH St
Iron Mountain, MI 49801-2011
Phone (906) 221-0856

Other practice location 1

325 E H St
Iron Mountain, MI 49801-4760
Phone (906) 774-3300

Other identifiers 1

IdentifierTypeStateIssuer
82-4463331OtherMIST CHARLES PSYCHOTHERAPY SERVICES, PLLC

Other names 1

  • Dr. Karen Ann Olson Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240520001142 MI Practitioner - Clinical Psychologist 7911348107 Practice locations: Sterling Heights, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40220 Diane Dr
Sterling Heights, MI 48313-4006
Phone (906) 221-0856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Iron Mountain Counseling Center, Inc. PastSince Dec 15, 2019 Accepting new patients

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": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1487987269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 6TH ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498012011",
            "telephone_number": "906-221-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 E LUDINGTON ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498012918",
            "telephone_number": "906-239-9918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 E H St",
            "address_purpose": "LOCATION",
            "city": "Iron Mountain",
            "state": "MI",
            "postal_code": "498014760",
            "country_code": "US",
            "telephone_number": "906-774-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KAREN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST CHARLES PSYCHOTHERAPY SERVICES, PLLC",
            "identifier": "82-4463331",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "OLSON",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.