Active NPI
Maria Poulsen, LMSW
- Clinical Social Worker
- Anchorage, AK
National Provider Identifier
1760917934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 170934
- Practice address
- 701 W 41St Ave
Anchorage, AK 99503-6604 - Phone
- (907) 782-4566
- NPI assigned
- Apr 26, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | CSWM1161 | AK | |
| Clinical Social Worker | 1041C0700X | 170934 | AK | Primary |
Addresses
Primary practice location
701 W 41St Ave
Anchorage, AK 99503-6604
Mailing address
PO Box 5242
Twin Falls, ID 83303-5242
Phone (208) 310-0353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760917934 | Other | AK | INSURANCE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mpoulsen@alyeskacounselinggroup.com |
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 |
|---|---|---|---|
| CSWM1161 | AK | MD | Social Worker |
| 170934 | AK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680825600000",
"number": "1760917934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5242",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833035242",
"telephone_number": "208-310-0353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 W 41ST AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995036604",
"telephone_number": "907-782-4566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULSEN",
"first_name": "MARIA",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-26",
"last_updated": "2023-04-07",
"certification_date": "2023-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AK",
"license": "CSWM1161",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AK",
"license": "170934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "1760917934",
"state": "AK"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mpoulsen@alyeskacounselinggroup.com",
"affiliation": "N",
"address_1": "701 W 41st Ave",
"city": "Anchorage",
"state": "AK",
"country_code": "US",
"postal_code": "995036604",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.