Jon S Polen, M.S. , LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6120 Issued in OK

Practice address

606 Kihekah Ave
Pawhuska, OK 74056-4225

Phone

(918) 287-5426

NPI assigned

Mar 16, 2012

Sex

Male

Sole proprietor

No

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 OK

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Grand Lake Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, OK
  • NPI 1497762520
  Medicare reassignment NPD
• Anew Dawn Counseling Services LLC

  • Mental Health Counselor
  • Tulsa, OK
  • NPI 1033758453
  NPD
• Grand Lake Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD
• Grand Lake Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stillwater, OK
  • NPI 1598213977
  NPD
• Sassin and Associates

  • Case Management Agency
  • Tulsa, OK
  • NPI 1255775243
  NPD (past)

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

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1285909705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 E 15TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044611",
            "telephone_number": "918-949-4430",
            "fax_number": "918-949-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 KIHEKAH AVE",
            "city": "PAWHUSKA",
            "state": "OK",
            "postal_code": "740564225",
            "telephone_number": "918-287-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEN",
        "first_name": "JON",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.S. , LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-16",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "6120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee C Perrier
• Lindsay Ray Perry
• Loyce Mae Pester, LPN
• Kenneth Dewayne Pickens
• Francis B Pipestem
• Melissa Polizzi
• Joseph Pratt
• James R Priest, MD
• Melissa R Proffitt
• Pulse EMS of Ok, Inc.

• Mental Health Counselor in Pawhuska, OK
• Providers in Pawhuska, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.