JEFFREY LEWIS POLCZINSKI (NPI# 1306878368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306878368 |
| Entity Type | Individual |
| Full Name | JEFFREY LEWIS POLCZINSKI |
| Credential | PSYD |
| Practice Address |
5555 N Port Washington Rd Suite 304 Glendale WI 53217 |
| Practice Telephone | 4149679550 |
| Practice Fax Number | 4149679550 |
| Mailing Telephone | 4149679550 |
| Mailing Fax Number | 4149679550 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-03-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1641057 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39131300 | 05 | |
| WI | PSCYHOLOGIST LICENSE | 1641057 | 01 |
| Street Address |
5555 N PORT WASHINGTON RD SUITE 304 |
| City | GLENDALE |
| State | WI |
| Zip Code | 53217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831797224 | Jazmin Christine Binns | Counselor | 5555 N Port Washington Rd, Glendale, WI 53217-4929 | 2020-10-16 |
| 1700222338 | Judith Geralyn Tegge | Counselor | 5555 N Port Washington Rd, Suite 200, Glendale, WI 53217-4929 | 2013-05-22 |
| 1164738183 | Julie Rupena-reynolds | Counselor | 5555 N Port Washington Rd, 200, Glendale, WI 53217-4929 | 2010-08-27 |
| 1124291976 | Jeffrey L Polczinski Psyd LLC | Psychologist | 5555 N Port Washington Rd, Suite 304, Glendale, WI 53217 | 2008-04-11 |
| 1033207386 | Caroline G Schmidt | Psychologist | 5555 N Port Washington Rd, Suite 200, Glendale, WI 53217-4929 | 2006-10-11 |
| 1114020773 | Bruce Andrew Semon | Psychiatry & Neurology | 5555 N Port Washington Rd, #200, Glendale, WI 53217-4927 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736190 | Tyler Davis LLC | Psychologist | 8607 N 59th Ave Suite C-6, Glendale, AZ 85302 | 2020-10-05 |
| 1871155986 | Jane Bowman Lischwe | Psychologist | 1818 Verdugo Blvd Ste 205, Glendale, CA 91208-1435 | 2019-06-28 |
| 1689143356 | Michael Brendzal | Psychologist | 501 W Glenoaks Blvd # 307, Glendale, CA 91202-2896 | 2018-11-24 |
| 1902251002 | Michael David Mcgady Jr. | Psychologist | 4425 W Olive Ave Ste 151a, Glendale, AZ 85302-3843 | 2016-04-27 |
| 1366809790 | Hansen Behavioral Health A Psychological Corporation | Psychologist | 524 N Maryland Ave, Suite 1, Glendale, CA 91206-2266 | 2016-01-15 |
| 1326469461 | Alisa Angelone | Psychologist | 715 N Central Ave Ste 102, Glendale, CA 91203-1286 | 2013-12-16 |
| 1699020180 | Ziba Saatchian | Psychologist | 135 S Jackson St, Suite #204, Glendale, CA 91205-4916 | 2012-07-20 |
| 1003181967 | Daura M De Assis | Psychologist | 436 Palm Dr, # 6, Glendale, CA 91202-3215 | 2012-03-12 |
| 1134411655 | Bryan Choi | Psychologist | 710 S Central Ave Ste 300, Glendale, CA 91204-4614 | 2011-05-03 |
| 1194029298 | Mike Zussman | Psychologist | 5800 N Bayshore Dr Ste A250, Glendale, WI 53217-4543 | 2011-01-04 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on JEFFREY LEWIS POLCZINSKI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.