Poulsen, Corie J
Poulsen, Corie J is an sole proprietor health care provider with primary practice located at 140 Hansen St E Ste 9, Twin Falls ID 83301. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Poulsen, Corie J can be contacted via phone (208) 733-7941.Contact Information
Primary practice address
140 Hansen St E Ste 9
Twin Falls ID 83301
Phone: (208) 733-7941
Fax: (208) 733-5415
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LCPC-116 | Idaho |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LCPC-116 | Idaho |
Profile Details
| NPI number | 1881777456 |
|---|---|
| LBN Legal business name | Poulsen, Corie J |
| Credentials | LCPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881777456 | NPPES |
| Idaho | Other | 00010016857 | BLUE SHIELD |
| Idaho | Other | Q5795 | BLUE SHIELD |
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