Individual provider Active NPI

Lars Olson, LP

  • Clinical Psychologist
  • Ignacio, CO
National Provider Identifier
1568086536
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0006645 Issued in CO
Practice address
940 County Road 336
Ignacio, CO 81137-9606
Phone
(000) 000-0000
NPI assigned
Jun 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 PSY.0006645 CO Primary

Addresses

Primary practice location

940 County Road 336
Ignacio, CO 81137-9606

Mailing address

940 County Road 336
Ignacio, CO 81137-9606

Other identifiers 1

IdentifierTypeStateIssuer
9000257993MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000.6645COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Mental Health LLC CurrentSince Jun 1, 2020 Accepting new patients
Therapy Collective LLC Clinical CurrentSince Jan 1, 2025 Accepting new patients
Care Clinics, LLC Psychologist CurrentSince Apr 10, 2023 Accepting new patients
Notramic LLC Clinical PastSince Feb 23, 2025 Accepting new patients

Locations

1970 E 3rd Ave
Ste 101
Durango, CO 81301
Phone (970) 422-1716

1650 Madison Ave
Ste 102
Mankato, MN 56001
Phone (507) 210-8464

220 E Main St
Ste 1
Mankato, MN 56001
Phone (507) 345-7012

Organizations & group practices 4

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": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1568086536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 COUNTY ROAD 336",
            "city": "IGNACIO",
            "state": "CO",
            "postal_code": "811379606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 COUNTY ROAD 336",
            "city": "IGNACIO",
            "state": "CO",
            "postal_code": "811379606",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "LARS",
        "name_prefix": "Dr.",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-04",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000257993",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ignacio, CO

Sources for this page

Verify at the official NPI Registry.