Nicole Olson, LCSW, CSAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9135-123 Issued in WI

Practice address

121 W Main St
Port Washington, WI 53074-1813

Phone

(262) 284-8142

Fax

(262) 284-8104

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of OzaukeeGroup PAC ID 5698737450, 5 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 and National Provider Directory roles.

• County of Ozaukee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Washington, WI
  • NPI 1609867001
  Medicare reassignment Care Compare group NPD
• County of Ozaukee

  • Public Health or Welfare Agency
  • Port Washington, WI
  • NPI 1740475250
  NPD

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1780032607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741813",
            "telephone_number": "262-284-8142",
            "fax_number": "262-284-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741813",
            "telephone_number": "262-284-8142",
            "fax_number": "262-284-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "NICOLE",
        "credential": "LCSW, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16319-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9135-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Ann O'Malley-Larson, L.P.N.
• Colleen J O'Neil
• Tedmond R O'Reilly, MD
• Ohana Ambulance and Emergency Medical Service LLC
• Jessica Ollman
• Laura Owens, MSW, LCSW, CADC III
• Ozaukee County
• Ozaukee County
• Ozaukee County
• Ozaukee County Department Human Services

• Clinical Social Worker in Port Washington, WI
• Providers in Port Washington, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.