Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacqualine Polydoros, LCPC

Individual provider Mental Health Counselor · NPI 1396349379

Jacqualine Polydoros, LCPC is a Mental Health Counselor in Hagerstown, Maryland. Qualified in 2023, 3 years ago. Licensed in Maryland.

Years since qualifying
3
Licensed in
MD
In the registry since
2020
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

See every abbreviation used in this directory →

Practice location Address checks out

322 E Antietam St Ste 101
Hagerstown, MD 21740-5736
Phone: (301) 733-2431
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LC16950 (MD)

Record details

NPI number1396349379
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCPC
Sole proprietorNo
NPI enumeratedNovember 30, 2020
Last updated in NPPESDecember 29, 2025
Certification dateDecember 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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