Individual provider Active NPI

Megan K Polanin, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Washington, DC
National Provider Identifier
1669807301
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY1001040 Issued in DC
Practice address
2115 Wisconsin Ave NW Ste 200
Washington, DC 20007
Phone
(202) 944-5369
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY1001040 DC Primary

Addresses

Primary practice location

2115 Wisconsin Ave NW Ste 200
Washington, DC 20007

Mailing address

2115 Wisconsin Ave NW Ste 200
Washington, DC 20007-2265
Phone (202) 944-5369

Other practice location 1

1339 20th St
Santa Monica, CA 90404-2033
Phone (310) 829-8921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY1001040DCMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1669807301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 WISCONSIN AVE NW STE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072265",
            "telephone_number": "202-944-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 WISCONSIN AVE NW STE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20007",
            "telephone_number": "202-944-5369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1339 20th St",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904042033",
            "country_code": "US",
            "telephone_number": "310-829-8921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLANIN",
        "first_name": "MEGAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "DC",
            "license": "PSY1001040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.