BRUCE CRAIG POULSEN (NPI# 1376669085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376669085 |
| Entity Type | Individual |
| Full Name | BRUCE CRAIG POULSEN |
| Credential | PHD |
| Practice Address |
5770 S 1500 W Taylorsville UT 84123-5216 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8012653031 |
| Mailing Telephone | 8014421400 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
4849539-2501 | UT | Behavioral Health & Social Service Providers |
| Street Address |
5770 S 1500 W |
| City | TAYLORSVILLE |
| State | UT |
| Zip Code | 84123-5216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447238456 | Daniel Aaron Ontiveros | Social Worker | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2006-01-09 |
| 1629675376 | Amanda Diane Griffiths | Social Worker | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2020-10-06 |
| 1740800085 | Nicole Hansen | Social Worker | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2020-04-16 |
| 1407396518 | Trina Rae Stephens | Counselor | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2017-03-08 |
| 1255713582 | Eva Tukuafu | Social Worker | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2015-06-23 |
| 1831594290 | Yvonne Bouwman | Social Worker | 5770 S 1500 W, Bldg C, Taylorsville, UT 84123-5216 | 2014-10-28 |
| 1316366487 | Andrew Layne | Social Worker | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2014-04-15 |
| 1174949051 | Heidi Marie Block | Psychologist | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2014-03-15 |
| 1336488428 | Charles Wayne Trice Jr. | Social Worker | 5770 S 1500 W, C, Taylorsville, UT 84123-5216 | 2013-02-08 |
| 1336484740 | Jeffrey D Riekhof | Social Worker | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2012-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186837 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5792 South Redwood Road, Taylorsville, UT 84123 | 2020-08-27 |
| 1164040614 | Mark E Hutchinson | Counselor | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1396259321 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4082 South Redwood Road, West Valley Road, UT 84123 | 2017-11-29 |
| 1083131890 | Kelli Mcstotts | Counselor | 5689 S. Redwood Road, Taylorsville, UT 84123 | 2017-08-23 |
| 1740706571 | Laura B Ellsworth | Case Manager/Care Coordinator | 5667 So. Redwood Road, 6b, Salt Lake City, UT 84123 | 2017-08-14 |
| 1790214120 | Integrated Autism Therapies | Behavioral Analyst | 5984 S. Susquehanna, Murray, UT 84123 | 2017-06-08 |
| 1083163885 | Michael John Flint | Counselor | 5861 South Redwood Road, #24, Taylorsville, UT 84123 | 2016-09-22 |
| 1548716236 | Andres Ramos | Licensed Psychiatric Technician | 697 West 4170 South, Murray, UT 84123 | 2016-09-01 |
| 1467807040 | Sheryl R Schindler | Counselor | 5770 South 1550 West, Bldg G, Primary Children's Counseling Center, Taylorsville, UT 84123 | 2016-05-02 |
| 1730562141 | Megan Merica Snarr | Dentist | 597 West 5300 South, Murray, UT 84123 | 2015-07-02 |
| Find all providers in zip 84123 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114237765 | Stephanie Creekpaum | Psychologist | 5770 S 1500 W, Taylorsville, UT 84123 | 2010-10-18 |
| 1659605525 | Leah Kimberly Huhnke | Psychologist | 5689 S Redwood Rd Unit 27, Taylorsville, UT 84123-5499 | 2009-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1477913762 | Lisa Daniels | Psychologist | 4568 S Highland Dr Ste 260b, Salt Lake City, UT 84117-4236 | 2016-02-29 |
| 1609146091 | Parents Helping Parents | Psychologist | 11175 S Redwood Road, South Jordan, UT 84095-8208 | 2012-01-03 |
| 1356620264 | Tara Sharifan | Psychologist | 505 S Main St Ste 209, Bountiful, UT 84010-6398 | 2011-08-09 |
| 1386945566 | Annie Michol Deming | Psychologist | 5770 S 1500 W # G, Salt Lake City, UT 84123-5216 | 2010-11-04 |
| 1932421161 | Quinten J. Harvey | Psychologist | 4164 Open Crest Dr, South Jordan, UT 84095-7701 | 2010-02-15 |
| 1588829634 | Carla J Reyes | Psychologist | 4568 S Highland Dr Ste 100, Salt Lake City, UT 84117-4234 | 2008-07-28 |
| 1588871321 | Corinna Anne Porter | Psychologist | 90 West 200 South, Suite 2, Heber City, UT 84032 | 2007-05-17 |
| 1871640953 | Jared Scott Warren | Psychologist | 1190 North 900 East, 291 John Taylor Building, Byu, Provo, UT 84602-8626 | 2007-01-04 |
| 1265592083 | Fenster Corp. | Psychologist | 4505 Wasatch Blvd Ste 380, Salt Lake City, UT 84124-4733 | 2006-12-11 |
| Find all providers with the same taxonomy | ||||
| City | TAYLORSVILLE |
| Zip Code | 84123 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.