Mallory Olson, BS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8006-226 Issued in WI

Practice address

312 W Knapp St Ste B
Rice Lake, WI 54868-1631

Phone

(715) 836-0064

Fax

(715) 836-0065

NPI assigned

Jul 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mallory Daniels Former name

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, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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.

• Caillier Clinic LTD

  • Clinical Neuropsychologist
  • Eau Claire, WI
  • NPI 1659453058

  WI

  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1659050516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 STEIN BLVD STE B",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012674",
            "telephone_number": "715-836-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W KNAPP ST STE B",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681631",
            "telephone_number": "715-836-0064",
            "fax_number": "715-836-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MALLORY",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8006-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "DANIELS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Ann Olson-McRaith, MOTR/L, CLT
• Andrew Roland Olson, DPT
• Bria Carol Olson, MSW
• Kelly J Olson, NP
• Kristina Kay Olson, LPC
• Maya Olson, DDS
• Olson' Hearing Center LTD.
• Optimum Therapies of Rice Lake
• Optimum Therapies, LLC
• Osterbauer Drugs LTD

• All providers in Rice Lake, WI
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.