Timothy Polakowski, MSW, LISW-S, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1502338 Issued in OH

Practice address

314 Louisiana Ave
Perrysburg, OH 43551-1461

Phone

(567) 331-8601

NPI assigned

Jul 20, 2023

Sex

Male

Sole proprietor

No

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 OH

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Monarch Grief CenterGroup PAC ID 1254795909, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Monarch Grief Center

  • Community/Behavioral Health Agency
  • Perrysburg, OH
  • NPI 1073293569
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1871273276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 LOUISIANA AVE",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511461",
            "telephone_number": "567-331-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 LOUISIANA AVE",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511461",
            "telephone_number": "567-331-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAKOWSKI",
        "first_name": "TIMOTHY",
        "credential": "MSW, LISW-S, LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1502338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanchan M. Pillai, M.D.
• Abigail Plott
• Wendy A Plumley, FNP-C
• Kimberly Pohlman, CLD
• Janet Pointer, OTR/L
• Shauna Pollard
• Sheila Deborah Post, M.S.W., L.I.S.W.
• Ravi Pothireddy, M.D.
• Nathaniel Potter
• Precision Spinal Care LLC

• Clinical Social Worker in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.