Kimberly Olson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6377-125 Issued in WI

Practice address

W4051 County Road NN
Elkhorn, WI 53121-4338

Phone

(262) 741-3200

Fax

(262) 741-3217

NPI assigned

Jan 26, 2015

Last updated

Aug 20, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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 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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stateline Mental Health ServicesGroup PAC ID 1658655865, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stateline Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beloit, WI
  • NPI 1538560255

  Professional

  Medicare reassignment Care Compare group NPD
• Western Montana Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Missoula, MT
  • NPI 1912079328

  Professional

  NPD (past)

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1558751826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 WILEMAN DR",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535341642",
            "telephone_number": "608-751-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W4051 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214338",
            "telephone_number": "262-741-3200",
            "fax_number": "262-741-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KIMBERLY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6377-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna E Novotny
• Anna Nusbaum, MD
• Danielle Obannon
• Terra Marie Olsen
• Angeline Olson, RN
• Open Arms Free Clinic
• Steven William Ortell, MD
• Jessica Ottow
• Kirk Jihyon Pak, M.D., PH.D., M.SC.
• Janis M Paonessa, M.A., LMFT

• Professional Counselor in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.