Provider Demographics
NPI:1407257801
Name:POLEON, CICELY ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:CICELY
Middle Name:ELIZABETH
Last Name:POLEON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CICELY
Other - Middle Name:ELIZABETH
Other - Last Name:LEWIS-POLEON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:801 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-5206
Mailing Address - Country:US
Mailing Address - Phone:321-926-1774
Mailing Address - Fax:407-523-1160
Practice Address - Street 1:801 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5206
Practice Address - Country:US
Practice Address - Phone:321-926-1774
Practice Address - Fax:407-523-1160
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health