Jeremiah Lee Olson in Winnebago - Addiction (substance Use Disorder)
Jeremiah Lee Olson - NPI 1952455800
Jeremiah Lee Olson is a Addiction (substance Use Disorder) in Winnebago, Wisconsin. Jeremiah Lee Olson practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Jeremiah Lee Olson is 1952455800. The last update date is 2010-10-28.
Jeremiah Lee Olson's current location address is 1300 South Drive, Winnebago, Wisconsin. You can contact this provider via phone number 9202354910 and fax number 9202372043. The mailing address for Jeremiah Lee Olson is 1300 South Drive, Winnebago, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeremiah Lee Olson |
|---|---|
| Address | 1300 South Drive, Winnebago, Wisconsin |
| Phone Number | 9202354910 |
| Fax Number | 9202372043 |
| Sole Proprietor | N |
| Credentials | CSAC, ICS |
NPI Number Detail
| NPI Number | 1952455800 |
|---|---|
| Provider Enumeration Date | 2007-01-22 |
| Last Updated Date | 2010-10-28 |
Provider Mailing Address Detail
| Address | 1300 South Drive |
|---|---|
| City | Winnebago |
| State | Wisconsin (WI) |
| Post Code | 549850009 |
| Phone Number | 9202354910 |
| Fax Number | 9202372043 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 11698 |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39171000 | WI | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Jeremiah Lee Olson?
The Jeremiah Lee Olson has been issued the NPI (National Provider Identifier) 1952455800 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Jeremiah Lee Olson is geographically located?
The Jeremiah Lee Olson is physically situated at the following location: 1300 South Drive, Winnebago, WI, 549850009.
What is Jeremiah Lee Olson's area of expertise and its corresponding taxonomy classification?
The Jeremiah Lee Olson's field of specialization is Addiction (substance Use Disorder), and it falls under the taxonomy code 101Ya0400X, which categorizes healthcare providers based on their areas of practice.
On what date did Jeremiah Lee Olson receive its 1952455800 assignment from the Centers for Medicare & Medicaid Services?
The Jeremiah Lee Olson was assigned its 1952455800 on 2007-01-22, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Jeremiah Lee Olson most recently updated or revised?
The information pertaining to Jeremiah Lee Olson, including its address, specialty, and other relevant details, was last updated or revised on 2010-10-28.