Jennifer Shanti Olson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166000872 Issued in IL

Practice address

8616 Northern Ave
Rockford, IL 61107-5309

Phone

(815) 332-6000

NPI assigned

Jan 4, 2013

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1770820128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073877",
            "telephone_number": "815-387-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8616 NORTHERN AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075309",
            "telephone_number": "815-332-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JENNIFER",
        "middle_name": "SHANTI",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Oldenburg, LPC
• Megan Olejnik, LCSW
• Stephanie Oleston, LATC
• Phil Oliveri, PT
• Thomas Stephen Olsen, DPT
• Kaitlyn O Olson
• Kyle Olson, D.C.
• Laura Olson, RN
• Erika J Oltmanns, RD, LDN
• Oman & Oman Counseling, Inc.

• Marriage & Family Therapist in Rockford, IL
• Providers in Rockford, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.