Laurie Polen, MA, CCC-SLP, BCBA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101004275 Issued in MI

Practice address

7329 Westchester
West Bloomfield, MI 48322-2874

Phone

(248) 613-9740

NPI assigned

Apr 17, 2017

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Inspire Autism LLC

  • Behavior Analyst
  • Novi, MI
  • NPI 1003438052
  NPD (past)

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1780118711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7329 WESTCHESTER",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7329 WESTCHESTER",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222874",
            "telephone_number": "248-613-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEN",
        "first_name": "LAURIE",
        "credential": "MA, CCC-SLP, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401000516",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101004275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Sue Plasko, OTR
• Laura Plassey
• Platinum Plus Care Services
• PNG RX Consulting LLC
• Colleen Pocs, MS, OTRL
• Mina Poles
• Amanda Polk, LMSW
• Austin Polutanovich
• Jillian Pompo
• Anne Gillis Pond, MD

• Speech-Language Pathologist in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.