Shelley Poulsen, L.I.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120463 Issued in MA

Practice address

825 Beacon St Ste 7
Newton Centre, MA 02459-1834

Phone

(617) 519-3242

NPI assigned

Jun 1, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1659809887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 2ND AVE UNIT 4104",
            "city": "NEEDHAM HEIGHTS",
            "state": "MA",
            "postal_code": "024942961",
            "telephone_number": "508-423-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 BEACON ST STE 7",
            "city": "NEWTON CENTRE",
            "state": "MA",
            "postal_code": "024591834",
            "telephone_number": "617-519-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSEN",
        "first_name": "SHELLEY",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Parmely, ED.D.
• Vipul Patel
• Joanie A. Piken I, M.S.W.
• Carol P Podolsky, M.D.
• Marion Cooper Pollock, M.S. CCC
• Leila Pruscino
• Megan Raichelson, PSYD
• Stephen Rellas, D.M.D.
• Retinacheck, Inc.
• Patricia Ellen Rice, LICSW

• Clinical Social Worker in Newton Centre, MA
• Providers in Newton Centre, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.