Jessica Eileen Polubinsky, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39003405A Issued in IN

Practice address

3702 Rupp Dr Ste 5
Fort Wayne, IN 46815-4526

Phone

(260) 615-3360

NPI assigned

Dec 23, 2024

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

Other names 1

• Jessica Eileen Williams 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.

• Wholistic Wellness Counseling and Consulting LLC

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1578108767
  NPD Authorized official

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1437967460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 RIVERMET AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054232",
            "telephone_number": "260-602-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 RUPP DR STE 5",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154526",
            "telephone_number": "260-615-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLUBINSKY",
        "first_name": "JESSICA",
        "middle_name": "EILEEN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003405A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WILLIAMS",
            "middle_name": "EILEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gregg S Pollander, MD
• Debra Polley, LCSW
• David L Pollifrone, MD
• Benjamin Pollock, MS
• Cole Matthew Polnow, PA
• Stephanie Pomfred
• Brittany Pompei, ATC
• Amy M Pond, PA
• Gregory C Pond, M.D.
• William W Pond, MD

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.