Provider Demographics
NPI:1770248726
Name:OLSEN, JAMES DAYTON
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DAYTON
Last Name:OLSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 SPRING VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:22405-1910
Mailing Address - Country:US
Mailing Address - Phone:540-424-8808
Mailing Address - Fax:
Practice Address - Street 1:7424 BROCK RD
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-2002
Practice Address - Country:US
Practice Address - Phone:540-582-3980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010951.101Y00000X
VA0701010951101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor