NICHOLAS OLSEN LCSW
NPI 1104223510
Social Worker - Clinical in Kenosha, WI

Q: What is Nicholas Olsen's NPI number?

The NPI number for Nicholas Olsen is 1104223510. It was assigned to this individual provider in the NPPES registry on December 1, 2014.

Q: What is Nicholas Olsen's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Olsen was last updated on June 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 01, 2014PECOS EnrolledAccepts Medicare Assignment

6121 GREEN BAY RD STE 200, KENOSHA, WI 53142(262) 674-3718 Get Directions Write a Review

NPPES record last updated: June 20, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 20, 2023, Jul 30, 2021, Jun 19, 2018 (3 updates tracked since 2018).

On this page

About Nicholas Olsen Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS OLSEN LCSW (NPI 1104223510) is an individual clinical provider in Kenosha, Wisconsin, licensed in Wisconsin (8919) and active in the NPI registry since December 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1104223510

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameNICHOLAS OLSENCredential: LCSW

Location Address6121 GREEN BAY RD STE 200Kenosha, WI 53142-2931

Mailing Address6121 Green Bay Rd Ste 200Kenosha, WI 53142-2931 · (262) 674-3718

Phone(262) 674-3718

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateDecember 1, 2014

Last NPPES UpdateJune 20, 20233 updates tracked since enumeration

NPPES CertifiedJune 20, 2023

✔ NPI 1104223510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in WI · 8919

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

6121 GREEN BAY RD STE 200, Kenosha, WI 53142

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Network Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicholas Olsen Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092070813

PECOS Enrollment IDI20180529001795

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Nicholas Olsen reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Advance Clinical Services

Same address

Clinical

6121 GREEN BAY RD STE 200
Kenosha, WI 53142

Reassigned Medicare billing, Wisconsin enrollment
8 clinicians in this Medicare group

NPI 1124791595 (262) 694-3718

Ascension Medical Group-Southeast Wisconsin Inc

33 mi

Anesthesiology

2301 N LAKE DR
Milwaukee, WI 53211

Reassigned Medicare billing, Wisconsin enrollment
1,343 clinicians in this Medicare group

NPI 1194473066 (414) 585-1000

Genesis Counseling Services Ltd.

59 mi

Mental Health (Including Community Mental Health Center)

1 S MAIN ST
Janesville, WI 53547

Reassigned Medicare billing, Wisconsin enrollment
11 clinicians in this Medicare group

NPI 1730273483 (608) 757-0404

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53142 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $53.90 – $163.24

Typical copayment $0.00 (range $13.47 – $40.81)

Most-billed visit code NA

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADVANCE CLINICAL SERVICES

Social Worker (Clinical)