Active NPI
Chantale Poulin
- Occupational Therapist
- Durham, NC
National Provider Identifier
1285881268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6829
- Practice address
- 610 W Morgan St Apt 111
Durham, NC 27701-2175 - Phone
- (858) 699-3584
- NPI assigned
- Aug 21, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 6829 | NC | Primary |
Addresses
Primary practice location
610 W Morgan St Apt 111
Durham, NC 27701-2175
Mailing address
610 W Morgan St Apt 111
Durham, NC 27701-2175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6829 | Other | NC | NC OT LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6829 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219276800000",
"number": "1285881268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 W MORGAN ST APT 111",
"city": "DURHAM",
"state": "NC",
"postal_code": "277012175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 W MORGAN ST APT 111",
"city": "DURHAM",
"state": "NC",
"postal_code": "277012175",
"telephone_number": "858-699-3584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULIN",
"first_name": "CHANTALE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-21",
"last_updated": "2008-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "6829",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC OT LICENSE",
"identifier": "6829",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.