Individual provider Active NPI

Richard Olson, L.C.S.W.

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1912020884
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012156 Issued in IL
Practice address
333 W 57TH St Apt 102
New York, NY 10019-3122
Phone
(917) 685-1181
NPI assigned
Apr 7, 2007
Last updated
Aug 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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 149012156 IL Primary

Addresses

Primary practice location

333 W 57TH St Apt 102
New York, NY 10019-3122

Mailing address

1300 W Belmont Ave
Ste 211
Chicago, IL 60657-3200
Phone (773) 880-2317

Other identifiers 3

IdentifierTypeStateIssuer
01636966OtherILBLUECROSS BLUESHIELD
600071671OtherILMAGELLIAN
469951OtherILVALUEOPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220322000978 NY Practitioner - Clinical Social Worker 0244322238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens Psychotherapy LCSW Services P.C.Group PAC ID 9931499639, 14 clinicians

Practice addresses (Care Compare)

9520 63Rd Rd
Suite J
Rego Park, NY 11374-1145
Phone 718459122518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Psychotherapy LCSW Services P.C. Clinical CurrentSince Nov 23, 2021 Accepting new patients
Olson and Hamilton Psychotherapy Services Inc. Clinical Current Accepting new patients
Richard Olson LCSW PLLC Clinical CurrentSince Aug 18, 2019 Accepting new patients
Terio Psychotherapy Services LCSW, P.C. Clinical CurrentSince Nov 1, 2022 Accepting new patients

Locations

1300 W Belmont Ave
Ste 211
Chicago, IL 60657
Phone (773) 880-2308

333 W 57th St
Apt 102
New York, NY 10019
Phone (212) 977-5835

9520 63rd Rd
Ste J
Rego Park, NY 11374
Phone 718459122518

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1912020884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "STE 211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "773-880-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W 57TH ST APT 102",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193122",
            "telephone_number": "917-685-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "01636966",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLIAN",
            "identifier": "600071671",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "469951",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.