Provider Demographics
NPI:1619858941
Name:OLSON, RONALD B (MAC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:B
Last Name:OLSON
Suffix:
Gender:M
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 W 47TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-6339
Mailing Address - Country:US
Mailing Address - Phone:605-593-4075
Mailing Address - Fax:605-401-4086
Practice Address - Street 1:3409 W 47TH ST STE 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-6339
Practice Address - Country:US
Practice Address - Phone:605-593-4075
Practice Address - Fax:605-401-4086
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD21067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty