Individual provider Active NPI

Jennifer Ann Olson, LICSW MSW MDIV

  • Clinical Social Worker
  • Danvers, MA
National Provider Identifier
1831135870
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113039 Issued in MA
Practice address
89 Newbury St Ste 101
Danvers, MA 01923-1098
Phone
(612) 364-1428
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 113039 MA Primary

Addresses

Primary practice location

89 Newbury St Ste 101
Danvers, MA 01923-1098

Mailing address

172 6TH St E Apt 1103
Saint Paul, MN 55101-1976
Phone (617) 512-9813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20050413000438 MA Practitioner - Clinical Social Worker 7113964982 Practice locations: Danvers, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

89 Newbury St
Suite 101
Danvers, MA 01923-1098
Phone (612) 364-1428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113039MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Suffolk Community Services Inc. CurrentSince Oct 20, 1997 Accepting new patients
Wilmington Family Counseling Service Inc PastSince Nov 1, 1996 Accepting new patients

Locations

301 Broadway
Chelsea, MA 02150
Phone (617) 889-4860

14 Porter St
East Boston, MA 02128
Phone (617) 569-3189

265 Beach St
Revere, MA 02151
Phone (781) 289-9331

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1831135870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 6TH ST E APT 1103",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551011976",
            "telephone_number": "617-512-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 NEWBURY ST STE 101",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231098",
            "telephone_number": "612-364-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICSW MSW MDIV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.