Provider Demographics
NPI:1861152027
Name:OLSEN, KRISTIN ANN (LPCC, LADC)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:ANN
Last Name:OLSEN
Suffix:
Gender:F
Credentials:LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1884 22ND ST NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-0618
Mailing Address - Country:US
Mailing Address - Phone:507-215-8260
Mailing Address - Fax:507-208-7737
Practice Address - Street 1:300 11TH AVE NW STE 112
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2739
Practice Address - Country:US
Practice Address - Phone:507-215-8260
Practice Address - Fax:507-208-7737
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306129101YA0400X
MN4272101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)