Elsie Diana Pulupuna, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

12288160-3501 Issued in UT

Practice address

180 N University Ave Ste 270
Provo, UT 84601-5648

Phone

(385) 283-7015

NPI assigned

Oct 14, 2020

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1851999619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N UNIVERSITY AVE STE 270",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846015648",
            "telephone_number": "385-283-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N UNIVERSITY AVE STE 270",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846015648",
            "telephone_number": "385-283-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULUPUNA",
        "first_name": "ELSIE",
        "middle_name": "DIANA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "12288160-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Vaughn Pugmire
• Taylor Pugmire
• Ryan Pulham, NP
• Rahim Pullom
• Elizabeth Ruth Pulsipher, MSW, CSW
• Caylie Marie Purcell
• Clarinis Purcell
• Gina Lelala Mabel Purcell, LCSW
• Leslie Diane Putnam, APRN, FNP-C
• Christina Elizabeth Pyne

• Mental Health Counselor in Provo, UT
• Providers in Provo, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.

Verify at the official NPI Registry.