Mr Wade Poulsen, in Salt Lake City, UT - Medicare Counselor Provider

Mr Wade Poulsen, is a medicare enrolled "Counselor - Mental Health" provider in Salt Lake City, Utah. His current practice location is 145 E 1300 S, Suite 501, Salt Lake City, Utah. You can reach out to his office (for appointments etc.) via phone at (385) 468-3559.

Mr Wade Poulsen is licensed to practice in Utah (license number 7966792-6004) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1427355650.

Contact Information

	Mr Wade Poulsen,
	145 E 1300 S, Suite 501, Salt Lake City, UT 84115-5482
	(385) 468-3559
	(385) 468-3560

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Wade Poulsen
Gender	Male
Speciality	Counselor - Mental Health
Location	145 E 1300 S, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427355650
Provider Enumeration Date: 02/24/2011
Last Update Date: 07/14/2014

Medicare PECOS Information:

PECOS PAC ID: 8022458967
Enrollment ID: I20240425003020

Medical Identifiers

Medical identifiers for Mr Wade Poulsen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427355650	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	7966792-6004 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Wade Poulsen allows following entities to bill medicare on his behalf.

Entity Name	Bear River Mental Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285736553 PECOS PAC ID: 0840102356 Enrollment ID: O20031103000725

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Wade Poulsen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Wade Poulsen, 145 E 1300 S, Suite 501, Salt Lake City, UT 84115-5482 Ph: (385) 468-3559	Mr Wade Poulsen, 145 E 1300 S, Suite 501, Salt Lake City, UT 84115-5482 Ph: (385) 468-3559

Reviews and Comments

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Mr Wade Poulsen, - Medicare Counselor in Salt Lake City, UT