Individual provider Active NPI

Cheri Noelle Polak, BA

  • Mental Health Counselor
  • Yakima, WA
National Provider Identifier
1689003444
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CG60414859 Issued in WA
Practice address
5301 Tieton Drive, Suite C
C/O Catholic Family & Child Service
Yakima, WA 98908-3478
Phone
(509) 965-7100
Fax
(509) 966-9750
NPI assigned
Nov 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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 CG60414859 WA Primary

Addresses

Primary practice location

5301 Tieton Drive, Suite C
C/O Catholic Family & Child Service
Yakima, WA 98908-3478

Mailing address

5301 Tieton Drive, Suite C
C/O Catholic Family & Child Service
Yakima, WA 98908-3478
Phone (509) 965-7100

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)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
CG60414859WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383350400000",
    "number": "1689003444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 TIETON DRIVE, SUITE C",
            "address_2": "C/O CATHOLIC FAMILY & CHILD SERVICE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083478",
            "telephone_number": "509-965-7100",
            "fax_number": "509-966-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 TIETON DRIVE, SUITE C",
            "address_2": "C/O CATHOLIC FAMILY & CHILD SERVICE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083478",
            "telephone_number": "509-965-7100",
            "fax_number": "509-966-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAK",
        "first_name": "CHERI",
        "middle_name": "NOELLE",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60414859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.