George Reginald Polk, LPC; LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701004680 Issued in VA

Practice address

3095 N Course Dr Apt 305
Pompano Beach, FL 33069-3370

Phone

(170) 357-7438

Fax

(954) 366-3539

NPI assigned

Nov 11, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• On the Right Path, LLC

  • Counselor
  • Pompano Beach, FL
  • NPI 1730782954
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1013244151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 N COURSE DR APT 305",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330693370",
            "telephone_number": "703-577-4389",
            "fax_number": "954-366-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 N COURSE DR APT 305",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330693370",
            "telephone_number": "170-357-7438",
            "fax_number": "954-366-3539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5675 Stone Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Centreville",
            "state": "VA",
            "postal_code": "201201667",
            "country_code": "US",
            "telephone_number": "703-577-4389",
            "fax_number": "703-532-5152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "GEORGE",
        "middle_name": "REGINALD",
        "name_prefix": "Mr.",
        "credential": "LPC; LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-11",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17414",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plus One Medical LLC
• Lauren Christine Poeder
• Pohlman Pain Associates LLC
• Chanise Point Du Jour
• Brittany Polansky, LCSW
• Lauren Pollak
• Pomp Pharmacy LLC
• Pomp RX Pharmacy LLC
• Pompano Beach Anesthesia Group LLC
• Pompano Beach Chiropractic Clinic, PA

• Professional Counselor in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.