Active NPI
Judith K. Olson, PH.D.
- Clinical Psychologist
- Laramie, WY
National Provider Identifier
1841399383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 75
- Practice address
- 526 Regency Dr
Laramie, WY 82070-5106 - Phone
- (307) 745-8475
- Fax
- (307) 745-5138
- NPI assigned
- Sep 21, 2006
- Last updated
- Oct 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 75 | WY | Primary |
Addresses
Primary practice location
526 Regency Dr
Laramie, WY 82070-5106
Mailing address
526 Regency Dr
Laramie, WY 82070-5106
Phone (307) 745-8475
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 830277301 82070 A001 | Other | WY | TRICARE |
| 830277301-001 | Other | WY | MBA |
| 138809 | Other | WY | MHN |
| OLS305030 | Other | WY | BLUECROSS/BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75 | WY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alpine Mental Health, LLC | Past | Accepting new patients | |
| Snowy Range Consulting, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Cheyenne, WY
- NPI 1245730399
-
- Psychologist
- Laramie, WY
- NPI 1922596196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1841399383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "526 REGENCY DR",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820705106",
"telephone_number": "307-745-8475",
"fax_number": "307-745-5138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "526 REGENCY DR",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820705106",
"telephone_number": "307-745-8475",
"fax_number": "307-745-5138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "JUDITH",
"middle_name": "K.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WY",
"license": "75",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "830277301 82070 A001",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBA",
"identifier": "830277301-001",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "138809",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUESHIELD",
"identifier": "OLS305030",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.