Provider Demographics
NPI:1760372734
Name:OLERUD, KATIE (LAC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:OLERUD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:CONROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:4401 COLEMAN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1371
Mailing Address - Country:US
Mailing Address - Phone:701-415-7632
Mailing Address - Fax:
Practice Address - Street 1:4401 COLEMAN ST STE 107
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1371
Practice Address - Country:US
Practice Address - Phone:701-415-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1921101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)