Active NPI
Shannon Kristi Olshove, M.S., L.L.P.
- Clinical Psychologist
- Traverse City, MI
National Provider Identifier
1912061359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301010639
- Practice address
- 3180 Racquet Club Dr
Suite G
Traverse City, MI 49684-4797 - Phone
- (231) 922-2885
- Fax
- (231) 922-0135
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 6301010639 | MI | Primary |
Addresses
Primary practice location
3180 Racquet Club Dr
Suite G
Traverse City, MI 49684-4797
Mailing address
422 Monroe St
Traverse City, MI 49684-2119
Phone (231) 947-7348
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301010639 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912061359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 MONROE ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842119",
"telephone_number": "231-947-7348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3180 RACQUET CLUB DR",
"address_2": "SUITE G",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496844797",
"telephone_number": "231-922-2885",
"fax_number": "231-922-0135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSHOVE",
"first_name": "SHANNON",
"middle_name": "KRISTI",
"name_prefix": "Mrs.",
"credential": "M.S., L.L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301010639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.