Provider Demographics
NPI:1033758859
Name:POLENSKE, LEAH GRACE (LPC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:GRACE
Last Name:POLENSKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 PALOMINO CT
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-2209
Mailing Address - Country:US
Mailing Address - Phone:971-409-1443
Mailing Address - Fax:
Practice Address - Street 1:2517 PALOMINO CT
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-2209
Practice Address - Country:US
Practice Address - Phone:971-409-1443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health