Maria Polacek, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2001011576 Issued in MO

Practice address

100 W Main St
Union, MO 63084-1363

Phone

(636) 583-1800

Fax

(636) 583-9836

NPI assigned

Jul 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maria Retherford Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Catholic Family Services Inc.

  • Mental Health Counselor
  • Union, MO
  • NPI 1154480176
  NPD (past)
• St Louis Counseling Inc

  • Voluntary or Charitable Agency
  • Fenton, MO
  • NPI 1053397133
  NPD (past)

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247702400000",
    "number": "1184854879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 WATSON RD",
            "address_2": "STE G101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261528",
            "telephone_number": "314-367-5500",
            "fax_number": "314-843-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W MAIN ST",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630841363",
            "telephone_number": "636-583-1800",
            "fax_number": "636-583-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLACEK",
        "first_name": "MARIA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2001011576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "RETHERFORD",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Peters, MED, LAT, ATC
• Heather E. Petrenko, LPC
• Anthony P. Phillips, LCSW
• Physician Groups LC
• Victoria Picha, LPC
• Megan L Porta, LPC
• Holly Porter, LPC
• Kristine Marie Posinski
• Grant Aloysius Powderly, DDS
• Preferred Family Healthcare

• Professional Counselor in Union, MO
• Providers in Union, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; 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.