Mr Jeremiah Lee Olson, CSAC, ICS is a
Counselor - Addiction (substance Use Disorder) based in Winnebago, Wisconsin. Mr Jeremiah Lee Olson is licensed to practice in Wisconsin (license number 11698) and his current practice location is
1300 South Drive, Winnebago, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(920) 235-4910.
NPI number for Mr Jeremiah Lee Olson is 1952455800 and his current mailing address is 1300 South Drive, Winnebago, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1952455800.
Healthcare Provider's Profile
| Full Name | Mr Jeremiah Lee Olson |
|---|
| Gender | Male |
|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
|---|
| Location | 1300 South Drive, Winnebago, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1952455800
- Provider Enumeration Date: 01/22/2007
- Last Update Date: 10/28/2010
Medical Identifiers
Medical identifiers for Mr Jeremiah Lee Olson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1952455800 | NPI | - | NPPES |
| 39171000 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 11698 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jeremiah Lee Olson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Jeremiah Lee Olson, CSAC, ICS
1300 South Drive,
Winnebago, WI 54985-0009
Ph: (920) 235-4910 | Mr Jeremiah Lee Olson, CSAC, ICS
1300 South Drive,
Winnebago, WI 54985-0009
Ph: (920) 235-4910 |
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