Active NPI
Elaine Marie Poulin, PHD
- Counseling Psychologist
- Fort Collins, CO
National Provider Identifier
1942255997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 3137
- Practice address
- 5131 S College Ave Unit B
Fort Collins, CO 80525-3968 - Phone
- (970) 631-4404
- NPI assigned
- May 24, 2006
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 3137 | CO | Primary |
Addresses
Primary practice location
5131 S College Ave Unit B
Fort Collins, CO 80525-3968
Mailing address
2017 Lookout Dr
Elaine Poulin
Windsor, CO 80550-4639
Phone (970) 631-4404
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Nov 14, 2016 through Nov 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3137 | CO | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479081600000",
"number": "1942255997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2017 LOOKOUT DR",
"address_2": "ELAINE POULIN",
"city": "WINDSOR",
"state": "CO",
"postal_code": "805504639",
"telephone_number": "970-631-4404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5131 S COLLEGE AVE UNIT B",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805253968",
"telephone_number": "970-631-4404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULIN",
"first_name": "ELAINE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2016-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CO",
"license": "3137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
- Poudre Valley Medical Group, LLC (UCHealth Medical Group)
- Poudre Valley Medical Group, LLC (UCHealth Medical Group)
- Poudre Valley Open MRI, LLC
- Poudre Valley Periodontics & Dental Implants
- Poudre Valley Radiation Oncology LLC
- Matthew David Pouliot, D.O.
- Anne Karen Poulson, MA, MED, LPC, NCC
- Jennifer Jean Poulson, FNP
- Kayla Elizabeth Poulson, MA, LPC
- David B Powell, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.