Provider Demographics
NPI:1306236567
Name:POULIN, KATHRYN MARION (LMSW, MPH)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARION
Last Name:POULIN
Suffix:
Gender:F
Credentials:LMSW, MPH
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MARION
Other - Last Name:ROMANSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, MPH
Mailing Address - Street 1:1111 AMSTERDAM AVENUE, SCRYMSER 3RD FLOOR
Mailing Address - Street 2:MT. SINAI ST. LUKE'S, INSTITUTE FOR ADVANCED MEDICINE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-523-5687
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVENUE, SCRYMSER 3RD FLOOR
Practice Address - Street 2:MT. SINAI ST. LUKE'S, INSTITUTE FOR ADVANCED MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-523-5687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078426104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker