Active NPI
Jerry Lynn Olson, LPC CADC III
- Professional Counselor
- Marshfield, WI
National Provider Identifier
1699849992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1802-125
- Practice address
- 252 S. Central Ave. Hergert and Gaziano
Suite # 21
Marshfield, WI 54449-1241 - Phone
- (715) 384-7579
- Fax
- (715) 384-8131
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | 1802-125 | WI | Primary |
Addresses
Primary practice location
252 S. Central Ave. Hergert and Gaziano
Suite # 21
Marshfield, WI 54449-1241
Mailing address
1703 Sawyer Dr
Apt. C
Marshfield, WI 54449-1241
Phone (715) 486-1557
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1802-125 | Other | WI | LPC |
| 1063 | Other | WI | CADC III |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1802-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hergert & Gazinao Family Counseling Services | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Marshfield, WI
- NPI 1396944757
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1699849992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1703 SAWYER DR",
"address_2": "APT. C",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544491241",
"telephone_number": "715-486-1557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "252 S. CENTRAL AVE. HERGERT AND GAZIANO",
"address_2": "SUITE # 21",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544491241",
"telephone_number": "715-384-7579",
"fax_number": "715-384-8131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "JERRY",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "LPC CADC III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "1802-125",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "1802-125",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CADC III",
"identifier": "1063",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marshfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.