Individual provider Active NPI

Pamela Phillips Olson, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1972524650
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2122-123 Issued in WI
Practice address
715 Hill St
Suite 200
Madison, WI 53705-3576
Phone
(608) 233-7431
Fax
(608) 647-8162
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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 2122-123 WI Primary

Addresses

Primary practice location

715 Hill St
Suite 200
Madison, WI 53705-3576

Mailing address

18549 County Hwy a
Richland Center, WI 53581-8662
Phone (608) 647-8220

Other identifiers 1

IdentifierTypeStateIssuer
39255500MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
2122-123WIMDClinical Social Worker
2122WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Uplands Counseling Associates, Inc. PastSince Oct 1, 2001 Accepting new patients
McPst Management Corporation PastSince Jan 1, 2005 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1972524650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18549 COUNTY HWY A",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535818662",
            "telephone_number": "608-647-8220",
            "fax_number": "608-647-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 HILL ST",
            "address_2": "SUITE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053576",
            "telephone_number": "608-233-7431",
            "fax_number": "608-647-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS OLSON",
        "first_name": "PAMELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2122-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39255500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.