POLLY L JASON PEER SUPPORTER
NPI 1407465826
Counselor - Addiction (Substance Use Disorder) in Lakewood, OH
Active since July 31, 2020
About Polly L Jason Peer Supporter NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
POLLY L JASON PEER SUPPORTER (NPI 1407465826) is an individual addiction (substance use disorder) provider in Lakewood, Ohio, licensed in Ohio (0001575) and active in the NPI registry since July 2020.
NPPES Registry Identity
NPI1407465826
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NamePOLLY L JASONCredential: PEER SUPPORTER
Location Address11720 EDGEWATER DR APT 816Lakewood, OH 44107-6730
Mailing Address11720 Edgewater Dr Apt 816Lakewood, OH 44107-6730 · (216) 798-0759
Phone(216) 798-0759
Sole ProprietorYes
Enumeration DateJuly 31, 2020
NPPES CertifiedJuly 31, 2020
✔ NPI 1407465826 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · 0001575
11720 EDGEWATER DR APT 816, Lakewood, OH 44107
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407465826, enumerated as an "individual" on July 31, 2020.
The provider is located at 11720 EDGEWATER DR APT 816 LAKEWOOD, OH 44107 and the phone number is (216) 798-0759.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
