Mark J Olson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16377 Issued in MN

Practice address

11708 Wayzata Blvd
Minnetonka, MN 55305-2014

Phone

(952) 544-0964

NPI assigned

Apr 11, 2013

Last updated

Apr 11, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthwise Psychology PAGroup PAC ID 2567685647, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthwise Psychology, PA

  • Clinical Psychologist
  • Maple Grove, MN
  • NPI 1184920753
  Medicare reassignment Care Compare group NPD
• Family Connections Counseling Center LLC

  dba Family Connections

  • Community/Behavioral Health Agency
  • Minnetonka, MN
  • NPI 1811228133
  Medicare reassignment NPD
• Scott M Yarosh, LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1144543265
  NPD

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1750724522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 W 16TH ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261816",
            "telephone_number": "612-836-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11708 WAYZATA BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052014",
            "telephone_number": "952-544-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Odin Olson, DDS
• Jay R Olson, OD
• Jonathan Michael Olson
• Kendall Marie Olson
• Macy Ruth Olson
• Mark Loren Olson, L.M.F.T.
• Meagan McCall Olson, LMFT
• Nia Marie Olson
• Rachael Olson
• Shukri Said Omar

• Clinical Social Worker in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.