Provider Demographics
NPI:1174619704
Name:OLSEN, MONICA JEAN (LMFT, LISAC)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:JEAN
Last Name:OLSEN
Suffix:
Gender:F
Credentials:LMFT, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3978
Mailing Address - Country:US
Mailing Address - Phone:541-636-0828
Mailing Address - Fax:458-205-8376
Practice Address - Street 1:1307 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3978
Practice Address - Country:US
Practice Address - Phone:541-636-0828
Practice Address - Fax:458-205-8376
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist