IndividualActive
Polly Jason, PEER SUPPORTER
NPI 1407465826 · Addiction (Substance Use Disorder) Counselor · Lakewood, OH
Provider details
- NPI number
- 1407465826
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- PEER SUPPORTER
- Sex
- Female
- Sole proprietor
- Yes
- License
- 0001575 (OH)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11720 Edgewater Dr Apt 816
Lakewood, OH 44107-6730
Phone: (216) 798-0759
Street-level locationGet directions
Mailing address
11720 Edgewater Dr Apt 816
Lakewood, OH 44107-6730
Registry dates
- Enumerated
- 2020-07-31
- Last updated
- 2020-07-31
- Certified
- 2020-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.