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DOMINIC POULIN LPCC
NPI 1972021368
Counselor - Mental Health in Minneapolis, MN

Active since September 06, 2017PECOS Enrolled
410 CHURCH ST SE, MINNEAPOLIS, MN 55455(612) 625-8400(612) 677-3211 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dominic Poulin Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMINIC POULIN LPCC (NPI 1972021368) is an individual mental health provider in Minneapolis, Minnesota, licensed in Minnesota (1096) and active in the NPI registry since September 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972021368
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDOMINIC POULINCredential: LPCC
Location Address410 CHURCH ST SEMinneapolis, MN 55455
Mailing Address410 Church St SeMinneapolis, MN 55455-0222 · (612) 624-8400 · Fax (612) 677-3211
Phone(612) 625-8400
Fax(612) 677-3211
Sole ProprietorNo
Enumeration DateSeptember 6, 2017
Last NPPES UpdateJuly 24, 2025
NPPES CertifiedJuly 24, 2025
✔ NPI 1972021368 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MN · 1096
410 CHURCH ST SE, Minneapolis, MN 55455
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dominic Poulin Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Dominic Poulin reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Regents Of The University Of Minnesota
Same address
Student Health
410 CHURCH ST SE
Minneapolis, MN 55455
  • Reassigned Medicare billing, Minnesota enrollment
  • 15 clinicians in this Medicare group
NPI 1295948818 (612) 625-8400
Nystrom & Associates, Ltd
7.5 mi
Clinical
1900 SILVER LAKE RD NW, SUITE 110
New Brighton, MN 55112
  • Reassigned Medicare billing, Minnesota enrollment
  • 794 clinicians in this Medicare group
NPI 1396750188 (651) 628-9566

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. STEPHANIE GRADY PA & NP
Family Medicine
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-2612
RICHARD JON FEIST MD
Family Medicine
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
REGENTS OF THE UNIVERSITY OF MINNESOTA
Clinic/Center (Student Health)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
JEREMY ADAM GOLDBERG LICSW
Social Worker (Clinical)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-1444
DR. SABA GHAZIMOGHADAM PH.D.
Psychologist (Counseling)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
JOY L JOHNSON-LIND LICSW
Social Worker (Clinical)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
MARY KATHERINE UTZ LICSW
Social Worker (Clinical)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-9194
MARILYN SUSAN JOSEPH MD
Obstetrics & Gynecology
410 CHURCH ST SE, BOYNTON HEALTH SERVICE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-5187

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominic Poulin's NPI number?

The NPI number for Dominic Poulin is 1972021368. It was assigned to this individual provider in the NPPES registry on September 6, 2017.

Where is Dominic Poulin located?

Dominic Poulin practices at 410 Church St SE, Minneapolis, MN 55455. The listed phone number is (612) 625-8400.

What is Dominic Poulin's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Dominic Poulin enrolled in Medicare?

Yes. Dominic Poulin is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Dominic Poulin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dominic Poulin reassigns Medicare benefits to 2 organizations: Regents Of The University Of Minnesota (Minneapolis, MN) and Nystrom & Associates, Ltd (New Brighton, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dominic Poulin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dominic Poulin accept?

Health plans from HealthPartners list Dominic Poulin as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dominic Poulin was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.