Active NPI
Kimberly Polsen
- Professional Counselor
- Denver, CO
National Provider Identifier
1528548005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0014773
- Practice address
- 1290 N Williams St Ste 205
Denver, CO 80218-2657 - Phone
- (240) 480-0152
- NPI assigned
- Aug 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC.0014773 | CO | Primary |
Addresses
Primary practice location
1290 N Williams St Ste 205
Denver, CO 80218-2657
Mailing address
3234 Navajo St Apt 205
Denver, CO 80211-3596
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 |
|---|---|---|---|
| LPC.0014773 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brave Embodiment Counseling LLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Professional Counselor
- Denver, CO
- NPI 1053828525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1528548005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3234 NAVAJO ST APT 205",
"city": "DENVER",
"state": "CO",
"postal_code": "802113596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 N WILLIAMS ST STE 205",
"city": "DENVER",
"state": "CO",
"postal_code": "802182657",
"telephone_number": "240-480-0152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLSEN",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0014773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.