Denise Marie Polacek, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1650 Issued in OR

Practice address

3000 Market St NE
Ste 414
Salem, OR 97301-1896

Phone

(503) 375-0174

Fax

(503) 375-0175

NPI assigned

May 14, 2006

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

Medicare fee-for-service enrollment

Enrolled in OR

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1147564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1861443871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MARKET ST NE",
            "address_2": "STE 414",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011896",
            "telephone_number": "503-375-0174",
            "fax_number": "503-375-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MARKET ST NE",
            "address_2": "STE 414",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011896",
            "telephone_number": "503-375-0174",
            "fax_number": "503-375-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLACEK",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-14",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "1650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PNW Birth & Family
• PNW Doulas
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• Dorka Podmajersky
• Megan Pokorny, PHARMD, RPH
• Vanessa Isabella Polanco
• Polaris Dental Specialists
• Wendy Poling, COTA
• Polk County Mental Health
• Polk Yamhill & Marion Child Treatment Services Inc

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.