Mary Jane Poulson, MA, NCC, LMHC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00005937 Issued in WA

Practice address

719 Jadwin Ave
Richland, WA 99352-4217

Phone

(509) 430-8626

Fax

(509) 943-2129

NPI assigned

Oct 25, 2006

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

Other identifiers 1

Other names 1

• Jane Poulson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Poulson Counseling PLLC

  • Mental Health Counselor
  • Richland, WA
  • NPI 1730538422
  NPD Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710061528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 JADWIN AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524217",
            "telephone_number": "509-430-8626",
            "fax_number": "509-943-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 JADWIN AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524217",
            "telephone_number": "509-430-8626",
            "fax_number": "509-943-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSON",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "MA, NCC, LMHC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00005937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2075572",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "POULSON",
            "credential": "MA, NCC, LMHC, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Seetharam Reddy Pothi Reddy, MD
• Heather M Potter, PA-C
• Jennifer Eileen Potts, DPT
• Michael Andrew Potts
• Poulson Counseling PLLC
• Eric Scott Powell, DDS
• Richard Kelly Powelson, LMHC
• Stata Joan Powers, LMT
• Jennille Prasad, RN
• Premier Anesthesia of Richland a Division of Premier Anesthesia, LLC

• Mental Health Counselor in Richland, WA
• Providers in Richland, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.