| Larissa Olson, Lcsw Pllc | |
|
2423 Mullan Rd Missoula MT 59808-1827 | |
| (406) 499-2472 | |
| Not Available |
| Full Name | Larissa Olson, Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2423 Mullan Rd, Missoula, Montana |
| Authorized Official Name and Position | Larissa Olson (OWNER) |
| Authorized Official Contact | 4062744652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larissa Olson, Lcsw Pllc 2423 Mullan Rd Missoula MT 59808-1827 Ph: (406) 499-2472 | Larissa Olson, Lcsw Pllc 2423 Mullan Rd Missoula MT 59808-1827 Ph: (406) 499-2472 |
| NPI Number | 1205390861 |
|---|---|
| Provider Enumeration Date | 01/29/2019 |
| Last Update Date | 03/05/2023 |
| Certification Date | 03/05/2023 |
| Medicare PECOS PAC ID | 0143560219 |
|---|---|
| Medicare Enrollment ID | O20190327003235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205390861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Larissa Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588138127 PECOS PAC ID: 1052651122 Enrollment ID: I20190327003257 |
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