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NEIL I OLSON LAC

Addiction Substance Use Disorder

Grand Forks, North Dakota

Provider NPI: 1336171255

Provider Information:
 NEIL I OLSON LAC
Gender: M
Not Sole Proprietor

Practice Location:
151 S 4TH ST SUITE 401 GRAND FORKS, ND 58201 US
Tel: 701-795-3000  Fax: 701-795-3050

Business Mailing Address:
151 S 4TH ST SUITE 401 GRAND FORKS, ND 58201 US
Tel: 701-795-3000  Fax: 701-795-3050

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
ND1429

Other Provider Identifiers:

IssuerNumberStateType
BCBS ND PROVIDER NUMBER015447ND01
054519ND05
BCBS MN PROVIDER NUMBER48B83OLMN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS ND - Page 1



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