Active NPI
Frederick J. Olson, LCSW
- Clinical Social Worker
- Biddeford, ME
National Provider Identifier
1700898293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC4696
- Practice address
- 2 Springbrook Dr
Biddeford, ME 04005-9443 - Phone
- (207) 282-1500
- Fax
- (207) 282-2581
- NPI assigned
- Aug 12, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC4696 | ME | Primary |
Addresses
Primary practice location
2 Springbrook Dr
Biddeford, ME 04005-9443
Mailing address
78 Atlantic PL
South Portland, ME 04106-2316
Phone (207) 842-7701
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 307930099 | Medicaid | ME | |
| 250610099 | Medicaid | ME |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1700898293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 ATLANTIC PL",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062316",
"telephone_number": "207-842-7701",
"fax_number": "207-842-7773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 SPRINGBROOK DR",
"city": "BIDDEFORD",
"state": "ME",
"postal_code": "040059443",
"telephone_number": "207-282-1500",
"fax_number": "207-282-2581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "FREDERICK",
"middle_name": "J.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC4696",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "307930099",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "250610099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Biddeford, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.