Provider Demographics
NPI:1902144587
Name:OLSON, CHRISTIAN DONALD (LMSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:DONALD
Last Name:OLSON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15501 METROPOLITAN PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-1684
Mailing Address - Country:US
Mailing Address - Phone:586-226-2822
Mailing Address - Fax:586-226-2833
Practice Address - Street 1:15501 METROPOLITAN PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-1684
Practice Address - Country:US
Practice Address - Phone:586-226-2822
Practice Address - Fax:586-226-2833
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010877861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical