Active NPI
Jeff N Olsgaard, MA, MDIV, NCC, LCPC
- Professional Counselor
- Gresham, OR
National Provider Identifier
1881723948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC C3060
- Practice address
- 1700 NW Civic Dr
Suite 310
Gresham, OR 97030-3770 - Phone
- (503) 666-8832
- Fax
- (503) 669-8641
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 867 - LCPC | MT | |
| Professional Counselor | 101YP2500X | LPC C3060 | OR | Primary |
Addresses
Primary practice location
1700 NW Civic Dr
Suite 310
Gresham, OR 97030-3770
Mailing address
PO Box 13765
Portland, OR 97213-0765
Phone (971) 266-0536
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 740233 | Other | MT | BLUECROSS BLUESHIELD |
| 1881723948 | Other | NATIONAL PROVIDER IDENTIF | |
| 12168943 | Other | COUNCIL FOR AFFORDABLE QUALITY HEALTHCARE (CAQH) | |
| 252790 | Medicaid | MT |
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 867 - LCPC | MT | MD | Professional Counselor |
| LPC C3060 | OR | MD | Professional Counselor |
Interoperability endpoints
- lifestancehealth.jeffolsgaard@148835.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369612800000",
"number": "1881723948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13765",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972130765",
"telephone_number": "971-266-0536",
"fax_number": "888-875-7309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 NW CIVIC DR",
"address_2": "SUITE 310",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303770",
"telephone_number": "503-666-8832",
"fax_number": "503-669-8641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSGAARD",
"first_name": "JEFF",
"middle_name": "N",
"credential": "MA, MDIV, NCC, LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2013-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MT",
"license": "867 - LCPC",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "LPC C3060",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "740233",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL PROVIDER IDENTIF",
"identifier": "1881723948",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNCIL FOR AFFORDABLE QUALITY HEALTHCARE (CAQH)",
"identifier": "12168943",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "252790",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.