Stacie Lynn Olson, APRN, ARNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R155047-8 Issued in MN

Practice address

819 30TH Ave S Ste 206
Moorhead, MN 56560-5054

Phone

(218) 477-1353

Fax

(218) 477-1354

NPI assigned

Oct 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, WA, MN3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Mental Health Clinic PLLCGroup PAC ID 6204216070, 5 clinicians

Jamestown S'Klallam TribeGroup PAC ID 2365349495, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: solson1997814@wm.providencedirect.org

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.

• Jamestown S'Klallam Tribe

  • Federally Qualified Health Center (FQHC)
  • Sequim, WA
  • NPI 1134181555
  Medicare reassignment Care Compare group NPD
• Midwest Mental Health Clinic PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fargo, ND
  • NPI 1861877052

  MN

  Medicare reassignment Care Compare group
• Jamestown S'Klallam Tribe

  • Family Medicine Physician
  • Sequim, WA
  • NPI 1528809761
  NPD

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1669756755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 30TH AVE S STE 206",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605054",
            "telephone_number": "182-477-1353",
            "fax_number": "218-477-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 30TH AVE S STE 206",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605054",
            "telephone_number": "218-477-1353",
            "fax_number": "218-477-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "STACIE",
        "middle_name": "LYNN",
        "credential": "APRN, ARNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "4287",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R26651",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61125257",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R155047-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Arlene Olson
• Isabelle Anna Olson
• Jayson Olson
• Katherine Olson, BCBA, LABA
• Sarah Ray Olson
• Amanda Oney, NP
• Sarah Priscilla Opitz, BA, LSW, LADC
• Georgette Mawuena Opoku
• Paige Orr
• Veronica Ortega

• Psychiatric/Mental Health Nurse Practitioner in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.