Provider Demographics
NPI:1235905860
Name:POLACEK, RILEY MERCEDES
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:MERCEDES
Last Name:POLACEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HEINZ ST APT C226
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5968
Mailing Address - Country:US
Mailing Address - Phone:724-980-4413
Mailing Address - Fax:
Practice Address - Street 1:300 HEINZ ST APT C226
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5968
Practice Address - Country:US
Practice Address - Phone:724-980-4413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor