Provider Demographics
NPI:1396885240
Name:POLONSKY, BARBARA M (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:M
Last Name:POLONSKY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 AVER CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-1457
Mailing Address - Country:US
Mailing Address - Phone:410-227-9074
Mailing Address - Fax:410-992-0366
Practice Address - Street 1:5122 AVER CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-1457
Practice Address - Country:US
Practice Address - Phone:410-227-9074
Practice Address - Fax:410-992-0366
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD061131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical