Jessica Hayley Pollak, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.2204271 Issued in OH

Practice address

21625 Chagrin Blvd Ste 200
Beachwood, OH 44122-5364

Phone

(216) 777-8834

NPI assigned

Feb 19, 2021

Sex

Female

Sole proprietor

Yes

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 Oct 20, 2024 through Oct 20, 2026

Medicare enrollment (NPD)

Not enrolled

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.

• Cleveland Health and Wellness Center

  • Mental Health Counselor
  • Rocky River, OH
  • NPI 1013371962
  NPD (past)

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1831782960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36042 MEADOWDALE DR",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441393063",
            "telephone_number": "216-337-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21625 CHAGRIN BLVD STE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225364",
            "telephone_number": "216-777-8834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8224 Mentor Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Mentor",
            "state": "OH",
            "postal_code": "440605743",
            "country_code": "US",
            "telephone_number": "440-392-2222 x308",
            "fax_number": "440-565-2349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLAK",
        "first_name": "JESSICA",
        "middle_name": "HAYLEY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C2002792",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2204271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tod R Podl, MD
• Elisa Poggi, MSW LSW
• Sharon Pogrebinsky
• Suresh Pola, M.D.
• Frumi Pollack, OTR/L
• Jeanne Polo, OTR/L
• Thomas Polony, CDCA
• Marita Pompeani
• Mark Lucas Poole, COUNSELOR/CDCA
• Anderson J Pope

• Mental Health Counselor in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.