DOMINIC POULIN (NPI# 1972021368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972021368 |
| Entity Type | Individual |
| Full Name | DOMINIC POULIN |
| Credential | LPCC |
| Practice Address |
410 Church St Se Minneapolis MN 55455 |
| Mailing Address |
410 Church St Se Minneapolis MN 55455-0222 |
| Practice Telephone | 6126264213 |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2017-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
CC01096 | MN | Behavioral Health & Social Service Providers |
| Street Address |
410 CHURCH ST SE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841283074 | Coralie Ann Pederson | Nurse Practitioner | 410 Church St Se, Minneapolis, MN 55455-0222 | 2005-08-23 |
| 1073155438 | Chee Her | Social Worker | 410 Church St Se, Minneapolis, MN 55455-0222 | 2019-10-16 |
| 1447802236 | Seth Christman | Psychologist | 410 Church St Se, Minneapolis, MN 55455-0222 | 2019-07-11 |
| 1689230450 | Nicholas Edward Peterson | Physical Medicine & Rehabilitation | 410 Church St Se, Minneapolis, MN 55455-0222 | 2019-05-16 |
| 1073085718 | Cassandra Patricia Price | Social Worker | 410 Church St Se, Minneapolis, MN 55455-0222 | 2018-12-19 |
| 1912475450 | Jennifer Arnold | Physical Therapist | 410 Church St Se, Minneapolis, MN 55455-0222 | 2018-11-02 |
| 1033686480 | Emily Rischall Price | Psychologist | 410 Church St Se, Minneapolis, MN 55455-0222 | 2018-10-24 |
| 1790262707 | Hannah Marie Serwe | Social Worker | 410 Church St Se, Minneapolis, MN 55455-0222 | 2018-07-23 |
| 1861908261 | Ann Zedginidze | Counselor | 410 Church St Se, Minneapolis, MN 55455-0222 | 2017-12-20 |
| 1487175253 | Ben Andrew Mattson | Counselor | 410 Church St Se, Minneapolis, MN 55455-0222 | 2017-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715679 | Kara Biscobing | Nurse Anesthetist, Certified Registered | M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 | 2020-09-18 |
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1952922148 | Jacob Laurence Tigner | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-29 |
| 1710507538 | Rachael Grundman | Student in an Organized Health Care Education/Training Program | 420 Delaware St, Mmc 395, Minneapolis, MN 55455 | 2020-04-22 |
| 1497375240 | Sanjay Dhawan | Student in an Organized Health Care Education/Training Program | 420 Delaware St. Se, Mmc 195, Minneapolis, MN 55455 | 2020-04-22 |
| 1508486549 | Dariel Andres Diaz | Student in an Organized Health Care Education/Training Program | 420 Se Delaware Street, Mmc 195, Minneapolis, MN 55455 | 2020-04-20 |
| 1275186280 | Kerem Ozturk | Radiology | B-226 Mayo Memorial Building, Mmc 292 420 Delaware Street S.e., Minneapolis, MN 55455 | 2019-07-18 |
| 1275194631 | Andres Jose Gonzalez Coba | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se Mmc 284, Minneapolis, MN 55455 | 2019-06-26 |
| 1841850278 | Brendan Andrew Schleyer | Dentist | 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 | 2019-06-18 |
| 1932767399 | Claire-audrey Y Bayan | Student in an Organized Health Care Education/Training Program | 420 Delaware Street, Mmc 98, Minneapolis, MN 55455 | 2019-05-31 |
| Find all providers in zip 55455 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356949432 | Ives Kenneth Wittman | Counselor | 1828 Jefferson St Ne, Minneapolis, MN 55418-4427 | 2020-10-12 |
| 1194331397 | Link Psychotherapy Ltd | Counselor | 4749 Chicago Ave # Ic, Minneapolis, MN 55407-3556 | 2020-09-22 |
| 1538775143 | Elise Nathalie Meger | Counselor | 3033 Excelsior Blvd Ste 215, Minneapolis, MN 55416-5274 | 2020-09-18 |
| 1508472341 | Healing Path Center, LLC | Counselor | 2203 James Ave N, Minneapolis, MN 55411-1930 | 2020-09-17 |
| 1386258143 | Breakthrough Therapy Center, LLC | Counselor | 2833 13th Ave S Ste 216, Minneapolis, MN 55407-1417 | 2020-08-31 |
| 1740893957 | Amzie Elizabeth Reeves | Counselor | 2010 E Hennepin Ave Ste 2-110, Minneapolis, MN 55413-2760 | 2020-08-26 |
| 1548870512 | Community Solutions Services Inc | Counselor | 3043 2nd Ave South, Suite 101, Minneapolis, MN 55408 | 2020-08-05 |
| 1063020931 | Grandpa & Grandma Adult Day Care, Inc. | Counselor | 2518 N 2nd St Ste 116, Minneapolis, MN 55411-2259 | 2020-07-16 |
| 1932724812 | Demi Rose Mancini | Counselor | 900 S 8th St Bldg 4th, Minneapolis, MN 55404-1292 | 2020-06-16 |
| 1891322277 | Susan Marie Daub | Counselor | 1330 Lagoon Ave Fl 4, Minneapolis, MN 55408-2885 | 2020-03-25 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55455 |
Please comment or provide details below to improve the information on DOMINIC POULIN.
| 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.