Individual provider · Type 1 NPI

Jessica Marie Polovtsev, LPC

Professional Counselor · Conway, AR

NPI number 1194950774 Active

Practice location

350 Salem Rd Ste 1
Conway, AR 72034-6166

Fax (501) 329-5508

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XP1206061 (AR)
Professional Counselor Primary 101YP2500XP1206061 (AR)

Professional Counselor: Definition to come...

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About NPI 1194950774

Jessica Marie Polovtsev, LPC's National Provider Identifier is 1194950774, issued on May 26, 2009. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Conway, AR. The record was last updated on Jul 21, 2020.