Mitchell Lee Olson, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4154 Shoreline Dr Ste 202
Spring Park, MN 55384-5606

Phone

(612) 562-9880

NPI assigned

Jul 30, 2018

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

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.

• Mindfully Healing Inc.

  • Mental Health Counselor
  • Spring Park, MN
  • NPI 1235757600

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1831677103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 LAKEWOOD CIR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553872500",
            "telephone_number": "763-245-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4154 SHORELINE DR STE 202",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553845606",
            "telephone_number": "612-562-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 MN-7 E, Hutchinson, MN",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "MN",
            "postal_code": "553505538",
            "country_code": "US",
            "telephone_number": "763-245-0990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MITCHELL",
        "middle_name": "LEE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Mkapa
• Eric A Nagle, MD
• Steven Jay Nerheim, M.D.
• Novus Healthcare Group, LLC
• Archy Olson
• Kirsten Peckham, L.AC.
• Jerry R Petersen, MD
• PHS Lake Minnetonka LLC
• PHS/Lake Minnetonka, LLC
• Jennie Jean Pogreba, LICSW

• All providers in Spring Park, MN
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.