Jenica Polakow, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW79623 Issued in CA

Practice address

790 E Santa Clara St Ste 102
Ventura, CA 93001-2967

Phone

(805) 830-8331

NPI assigned

May 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Blue Moon Senior Counseling of California LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1447678990

  CA

  Medicare reassignment NPD
• Circle of Life Counseling Center

  • Marriage & Family Therapist
  • Thousand Oaks, CA
  • NPI 1568912541
  NPD (past)
• Sara Rector

  • Marriage & Family Therapist
  • Thousand Oaks, CA
  • NPI 1083078760
  NPD (past)

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

{
    "created_epoch": "1527292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1225529159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 BLUE MOUNTAIN CIR",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913625457",
            "telephone_number": "805-380-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E SANTA CLARA ST STE 102",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930012967",
            "telephone_number": "805-830-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAKOW",
        "first_name": "JENICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-26",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW79623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Plonska, RPH
• Mara Pober, BCBA
• Heather Poehler
• Point Break Recovery LLC
• Aimee Beth Pointner, PTA
• Shelcy Adriana Polanco
• Daisy Polido, LMFT
• Dillon Polito, MD
• Ronald Dale Pollack, M.D.
• Lianna Naomi Pollastrini

• Clinical Social Worker in Ventura, CA
• Providers in Ventura, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.