Provider Demographics
NPI:1124358874
Name:POLASEK, JUNE ELIZABETH (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:ELIZABETH
Last Name:POLASEK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 963
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260
Mailing Address - Country:US
Mailing Address - Phone:360-632-3353
Mailing Address - Fax:
Practice Address - Street 1:3268 HILBERG LN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:WA
Practice Address - Zip Code:98236
Practice Address - Country:US
Practice Address - Phone:360-632-3353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALMHC. LH.00006703101YM0800X
WALH0006703101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health