Provider Demographics
NPI:1952036709
Name:POLSKY, JESSICA RAE (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:POLSKY
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RAE
Other - Last Name:POLSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JESSICA SALTER
Mailing Address - Street 1:116 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3208
Mailing Address - Country:US
Mailing Address - Phone:610-733-9739
Mailing Address - Fax:
Practice Address - Street 1:116 SAWGRASS DR
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3208
Practice Address - Country:US
Practice Address - Phone:610-733-9739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012436101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health