Individual provider Active NPI

Marie Olson, LAC, BHP

  • Professional Counselor
  • Phoenix, AZ
National Provider Identifier
1902549942
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LAC-20446 Issued in AZ
Practice address
4343 N 16TH St
Phoenix, AZ 85016-5338
Phone
(602) 274-4343
Fax
(480) 573-3592
NPI assigned
Apr 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LAC-20446 AZ Primary

Addresses

Primary practice location

4343 N 16TH St
Phoenix, AZ 85016-5338

Mailing address

4343 N 16TH St
Phoenix, AZ 85016-5338
Phone (602) 274-4343

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

State licenses

LicenseStateTypeSpecialty
LAC-20446AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community 43 CurrentSince Apr 24, 2022 Accepting new patients
Highland Medical Center, PC PastSince Apr 24, 2022 Accepting new patients

Locations

4343 N 16th St
Phoenix, AZ 85016
Phone (602) 223-1711

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26465/brand/1/csg/1/fhir/r4

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": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1902549942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165338",
            "telephone_number": "602-274-4343",
            "fax_number": "480-573-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165338",
            "telephone_number": "602-274-4343",
            "fax_number": "480-573-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MARIE",
        "credential": "LAC, BHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LAC-20446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

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