Healthcare Provider Details

I. General information

NPI: 1992194948
Provider Name (Legal Business Name): JENNIFER CATHERINE POLIGNONI LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER CATHERINE GREENE

II. Dates (important events)

Enumeration Date: 01/14/2015
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W 6TH AVE
SPOKANE WA
99204-2404
US

IV. Provider business mailing address

22 S THOR ST
SPOKANE WA
99202-4855
US

V. Phone/Fax

Practice location:
  • Phone: 509-624-2868
  • Fax: 509-747-1730
Mailing address:
  • Phone: 509-532-2000
  • Fax: 509-532-2005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW611158271
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10670
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-42050
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: