Audrey Marie Polaski

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

9001 Miller Rd Ste 5
Swartz Creek, MI 48473-1115

Phone

(989) 324-9867

NPI assigned

Jan 21, 2019

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1699249854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 N TOWER BEACH RD",
            "city": "PINCONNING",
            "state": "MI",
            "postal_code": "486509736",
            "telephone_number": "989-324-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 MILLER RD STE 5",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484731115",
            "telephone_number": "989-324-9867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9001 Miller Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Swartz Creek",
            "state": "MI",
            "postal_code": "484731115",
            "country_code": "US",
            "telephone_number": "989-324-9867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3708 N Tower Beach Rd",
            "address_purpose": "LOCATION",
            "city": "Pinconning",
            "state": "MI",
            "postal_code": "486509736",
            "country_code": "US",
            "telephone_number": "989-324-9867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLASKI",
        "first_name": "AUDREY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106S00000X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix Rising Wellness LLC
• Samantha Pillow, LPC, CAADC
• Jeff J Plunkey, OT
• Plymouth Physical Therapy Specialists Limited Partnership
• Andrew John Pobocik, LMT
• Bonnie Anne Pounder, DDS
• Ppsmg Urgent Medical Care, PLLC
• Purely PT, LLC
• Purposeful Intentions Counseling Center, PLLC
• Rose Richardson

• Behavior Technician in Swartz Creek, MI
• Providers in Swartz Creek, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.