Provider Demographics
NPI:1306337167
Name:OLSON, SARA (LPC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 YARMOUTH GREENWAY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-5809
Mailing Address - Country:US
Mailing Address - Phone:608-205-8688
Mailing Address - Fax:
Practice Address - Street 1:2961 YARMOUTH GREENWAY DR STE 2
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5809
Practice Address - Country:US
Practice Address - Phone:608-205-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-28
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6060-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health