Provider Demographics
NPI:1538630306
Name:OLSON, CJ RACHELE (LPCC)
Entity type:Individual
Prefix:
First Name:CJ
Middle Name:RACHELE
Last Name:OLSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 POLLASKY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1159
Mailing Address - Country:US
Mailing Address - Phone:559-203-3775
Mailing Address - Fax:
Practice Address - Street 1:106 POLLASKY AVE STE D
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-1159
Practice Address - Country:US
Practice Address - Phone:559-203-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11497101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional