Jeffrey L Polczinski PSYD LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1641057 Issued in WI

Legal business name

JEFFREY L POLCZINSKI PSYD LLC

Practice address

5555 N Port Washington Rd
Suite 304
Glendale, WI 53217

Phone

(414) 967-9550

Fax

(414) 967-9550

NPI assigned

Apr 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey L Polczinski, PSYD

Title

Psychologist

Phone

(414) 967-9550

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vincent Joseph Adesso, PHD

  • Clinical Psychologist
  • Milwaukee, WI
  • NPI 1316907694
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1124291976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 N PORT WASHINGTON RD",
            "address_2": "SUITE 304",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-967-9550",
            "fax_number": "414-967-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N PORT WASHINGTON RD",
            "address_2": "SUITE 304",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-967-9550",
            "fax_number": "414-967-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY L POLCZINSKI PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "POLCZINSKI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "414-967-9550",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1641057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39131300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Ives
• James H. Langenkamp, M.D., S.C.
• Daniela A Jaramillo, PSY D
• Robert Joseph Jarvis, LCSW
• Hannah Jeanson
• John Peter Jendusa, LCSW
• Cassandra Lee Jenkins, RN
• Thomasina Marie Jenkins, LCSW,CSAC
• JM Janssen Dba Paramount Optical Lab
• John E. Darling, D.D.S., LLC

• All providers in Glendale, WI
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.