Provider Demographics
NPI:1417656448
Name:EPSTEIN, POLLY JONES
Entity Type:Individual
Prefix:
First Name:POLLY
Middle Name:JONES
Last Name:EPSTEIN
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 1:4941 STEEPLECHASE LN
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29449-5857
Mailing Address - Country:US
Mailing Address - Phone:843-442-3591
Mailing Address - Fax:
Practice Address - Street 1:4941 STEEPLECHASE LN
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:SC
Practice Address - Zip Code:29449-5857
Practice Address - Country:US
Practice Address - Phone:843-442-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC123861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical