Cathy Polonchak, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00940860 Issued in WV

Practice address

129 E. German St.
Shepherdstown, WV 25443-1784

Phone

(304) 876-3022

NPI assigned

Apr 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 25, 2013 through Nov 25, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Polonchak Educational Associates

  • Clinical Social Worker
  • Shepherdstown, WV
  • NPI 1720294226
  Authorized official Same address or phone

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1598984833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1784",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254431784",
            "telephone_number": "304-876-3022",
            "fax_number": "304-876-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 E. GERMAN ST.",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254431784",
            "telephone_number": "304-876-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLONCHAK",
        "first_name": "CATHY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10681",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00940860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine La Porte Palank, RN, MS, ANP-C
• Brittany Palaschak
• Thomas Yoon Park
• J. Peterson, PH.D., L.L.C.
• Polonchak Educational Associates
• Potomac Crossroads Counseling, LLC
• Potomac Integrative Health PLLC
• Potomac Integrative Health PLLC
• Pratima Chandler DDS PLLC
• Professional Sportscare & Rehab of West Virginia, LLC

• Clinical Social Worker in Shepherdstown, WV
• Providers in Shepherdstown, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.