Individual provider Active NPI

Polina Chernyak, LCSW

  • Mental Health Counselor
  • San Francisco, CA
National Provider Identifier
1356433205
Registry record updated Nov 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCS22641 Issued in CA
Practice address
2534 Judah St
San Francisco, CA 94122
Phone
(415) 449-2905
Fax
(415) 449-2901
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCS22641 CA Primary

Addresses

Primary practice location

2534 Judah St
San Francisco, CA 94122

Mailing address

2190 31St Ave
San Francisco, CA 94116-1637
Phone (415) 449-2905

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090714000505 CA Practitioner - Clinical Social Worker 0840342325 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2190 31St Ave
San Francisco, CA 94116-1637
Phone (415) 737-6655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS22641CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478304000000",
    "number": "1356433205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 31ST AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161637",
            "telephone_number": "415-449-2905",
            "fax_number": "415-449-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 JUDAH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94122",
            "telephone_number": "415-449-2905",
            "fax_number": "415-449-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNYAK",
        "first_name": "POLINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCS22641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.