Provider Demographics
NPI:1063003069
Name:OLSON PSYCHIATRY LLC
Entity type:Organization
Organization Name:OLSON PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:970-462-7126
Mailing Address - Street 1:627 24 1/2 RD STE F
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1277
Mailing Address - Country:US
Mailing Address - Phone:970-462-7126
Mailing Address - Fax:970-433-7624
Practice Address - Street 1:627 24 1/2 RD STE F
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1277
Practice Address - Country:US
Practice Address - Phone:970-462-7126
Practice Address - Fax:970-433-7624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty