Tamela Stacy Polanin, LCPC
Counselor, Professional in Vandalia, IL. Individual provider (NPI-1).
NPI number1982255592
StatusActive
Last updated in NPPESNov 28, 2024
Details
- NPI
- 1982255592
- Entity type
- Individual (NPI-1)
- Name
- Tamela Stacy Polanin
- Credential
- LCPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 25, 2019
- Certification date
- Nov 28, 2024
- Last updated
- Nov 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180.012372 | IL | Yes |
| 101YM0800X | Counselor, Mental Health | 180.012372 | IL |
Practice location
1703 W Fletcher StVandalia, IL 62471-3117
Phone 618-283-8750
Mailing address
2339 N 2000 StSaint Elmo, IL 62458-4175
Phone 618-292-7373
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