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General NPI Number Information
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NPI Number | 1083403984
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Entity Type | Organization
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Legal Business Name | POLESTAR PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 346 RIDGE RD
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City | WASHINGTON GROVE
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State | MD
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Zip | 20880-2000
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Country | US
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Telephone | 202-710-6883
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 843
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City | WASHINGTON GROVE
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State | MD
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Zip | 20880-0843
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Country | US
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Telephone | 202-710-6883
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Fax |
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Authorized Official
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Title or Position | OWNER AND THERAPIST
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Name | YULIA RYCHKOVA
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Credential | LCSWC
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Telephone | 202-710-6883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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