Stephanie Nicole Polan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017469 Issued in IL

Practice address

2501 Chatham Rd Ste N
Springfield, IL 62704-4188

Phone

(630) 219-0922

NPI assigned

Feb 15, 2016

Last updated

May 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Stephanie Nicole Zielinski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• The Audh Social Worker, PLLC

  • Clinical Social Worker
  • Huntley, IL
  • NPI 1376383836
  NPD Authorized official
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1205295557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11013 N WOODSTOCK ST",
            "address_2": "#276",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601426957",
            "telephone_number": "630-219-0922",
            "fax_number": "844-439-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE N",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "630-219-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAN",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017469",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ZIELINSKI",
            "middle_name": "NICOLE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Plunk, LCPC
• Plushcare Physician's Group LTD.
• Jackson Pocklington
• Edward J Ryan Poje, MD
• Suzanne M Pokrzywinski, CCC-A
• Natalie Anna Polechonski, DO
• Galina E Polevaya, PA-C
• Kevin Polk
• Mary Olivia Polk, M.D.
• Jennifer Lynn Pollock, MA CCCSLP

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.