Individual
MRS. CORIE J POULSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
140 HANSEN ST E, STE 9, TWIN FALLS, ID 83301
(208) 733-7941
(208) 733-5415
Mailing address
140 HANSEN ST E, STE 9, TWIN FALLS, ID 83301
(208) 733-7941
(208) 733-5415
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCPC-116
ID
101YP2500X
Professional Counselor
Primary
LCPC-116
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010016857
BLUE SHIELD
ID
01
—
Q5795
BLUE CROSS
ID
Enumeration date
10/24/2006
Last updated
09/11/2025
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