Provider Demographics
NPI:1972282770
Name:STRAND-POLYAK, KELSEY C (MSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:C
Last Name:STRAND-POLYAK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BUCK COVE TER
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-8218
Mailing Address - Country:US
Mailing Address - Phone:206-931-6354
Mailing Address - Fax:
Practice Address - Street 1:2 COMPTON DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2054
Practice Address - Country:US
Practice Address - Phone:206-931-6354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0193231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical