Individual provider Active NPI

Kathryn Louise Olsen, LCSW

  • Clinical Social Worker
  • Oklahoma City, OK
National Provider Identifier
1629601240
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2116 Issued in OK
Practice address
1131 E Britton Rd
Oklahoma City, OK 73131-2004
Phone
(405) 475-5505
NPI assigned
Feb 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 2116 OK Primary

Addresses

Primary practice location

1131 E Britton Rd
Oklahoma City, OK 73131-2004

Mailing address

1131 E Britton Rd
Oklahoma City, OK 73131-2004
Phone (405) 475-5505

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

State licenses

LicenseStateTypeSpecialty
2116OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Development and Intervention Services CurrentSince Aug 1, 2021 Accepting new patients
Traditions Hospice of Tulsa, LLC PastSince Feb 23, 2020 Accepting new patients

Locations

4805 Richmond Sq
#A
Oklahoma City, OK 73118
Phone (405) 767-1126

4805 Richmond Sq
Oklahoma City, OK 73118
Phone (405) 767-1126

Organizations & group practices 2

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": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1629601240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 E BRITTON RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731312004",
            "telephone_number": "405-475-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 E BRITTON RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731312004",
            "telephone_number": "405-475-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "KATHRYN",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "2116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.