Susan J Olson MD - Psychiatric Services LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

SUSAN J OLSON MD - PSYCHIATRIC SERVICES LLC

Practice address

333 Welcome Dr
Myrtle Beach, SC 29579-5374

Phone

(843) 712-1854

NPI assigned

Dec 17, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Nicholas J Licary, MBA

Title

Agent for Corporation

Phone

(843) 712-1854

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1669701827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 WELCOME DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795374",
            "telephone_number": "843-712-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 WELCOME DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795374",
            "telephone_number": "843-712-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN J OLSON MD - PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "LICARY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AGENT FOR CORPORATION",
        "authorized_official_telephone_number": "843-712-1854",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.