MARY JANE POULSON MA, NCC, LMHC, LPC
NPI 1710061528
Counselor - Mental Health in Richland, WA
NPI Status: Active since October 25, 2006
Contact Information
719 JADWIN AVE
RICHLAND, WA
ZIP 99352
Phone: (509) 430-8626
Fax: (509) 943-2129
- Individual
- Female
- Counselor
- Mental Health
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
About MARY POULSON
This page provides the complete NPI Profile along with additional information for Mary Poulson, a provider established in Richland, Washington with a medical specialization in Counselor, focusing in mental health . The healthcare provider is registered in the NPI registry with number 1710061528 assigned on October 2006. The practitioner's primary taxonomy code is 101YM0800X with license number LH00005937 (WA). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1710061528
- Provider Name
- MARY JANE POULSON MA, NCC, LMHC, LPC
- Other Name
- JANE POULSON MA, NCC, LMHC, LPC
- Other Name Type
- Professional Name (2)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 719 JADWIN AVE RICHLAND, WA 99352
- Location Phone
- (509) 430-8626
- Location Fax
- (509) 943-2129
- Mailing Address
- 719 JADWIN AVE RICHLAND, WA 99352
- Mailing Phone
- (509) 430-8626
- Mailing Fax
- (509) 943-2129
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-25-2006
- Last Update Date
- 07-21-2022
- Code Navigator
A mental health counselor like Mary Poulson provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Mary Poulson opted out of Medicare effective on 01-01-2024 until 01-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Mental Health
- Taxonomy Code
- 101YM0800X
- Type
- Behavioral Health & Social Service Providers
- License No.
- LH00005937
- License State
- WA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Legacy - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Gold 2300 Legacy - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Bronze Plan Legacy - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Gold Plan Legacy - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Regence Standard Silver Plan Legacy - EPO
- Silver 6500 Individual Connect - EPO
- Silver 6500 Legacy - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2075572 | MEDICAID (05) | WA |
Medicare Participation & PECOS Enrollment Status
Mary Poulson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-01-2024
Opt-Out End Date: 01-01-2026
Eligible to Order and Refer? No
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710061528, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 12 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710061528, enumerated as an "individual" on October 25, 2006.
The provider is located at 719 JADWIN AVE RICHLAND, WA 99352 and the phone number is (509) 430-8626.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
The provider might be accepting Accepts: BridgeSpan Health Company, Premera Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
