Provider Demographics
NPI:1306356050
Name:OLSON, BENJAMIN K (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:K
Last Name:OLSON
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 COMMERCIAL ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5207
Mailing Address - Country:US
Mailing Address - Phone:503-370-8050
Mailing Address - Fax:503-370-9982
Practice Address - Street 1:2001 COMMERCIAL ST SE STE 200
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5207
Practice Address - Country:US
Practice Address - Phone:503-370-8050
Practice Address - Fax:503-370-9982
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-2022101YP2500X
ORC8224101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional