Individual provider Active NPI

Stephanie Ann Olson, PHD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1669794616
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810007659 Issued in VA
Practice address
1515 Truemper St
San Antonio, TX 78236-5583
Phone
(210) 292-1602
NPI assigned
Feb 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8285 NC
Counselor 101Y00000X
Clinical Psychologist 103TC0700X 0810007659 VA Primary

Addresses

Primary practice location

1515 Truemper St
San Antonio, TX 78236-5583

Mailing address

1515 Truemper St
San Antonio, TX 78236-5583
Phone (210) 292-1602

Other practice location 1

1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-1602

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810007659VAMDClinical Psychologist
40122TXMDPharmacist
8285NCMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650672000000",
    "number": "1669794616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 TRUEMPER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782365583",
            "telephone_number": "210-292-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 TRUEMPER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782365583",
            "telephone_number": "210-292-1602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Wilford Hall Loop Bldg 4554",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-292-1602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-18",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8285",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.