Elizabeth Polomsky, RMHCI

Individual provider Active NPI Mental Health Counselor · Rockledge, FL

NPI 1124643010 · NPPES record last updated Jun 16, 2020

Key facts

NPI
1124643010
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
I18257 (FL)
Practice address
7095 Turner Rd
Rockledge, FL 32955-5728
Phone
(321) 446-2113
Fax
(321) 241-4605
NPI assigned
Jun 16, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1410 W Broadway St
Suite 107
Oviedo, FL 32765-6537
Phone (689) 266-5051

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231201002897 FL Practitioner - Mental Health Counselor 3678921590 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
I18257FLMDMental Health Counselor

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Abc Counseling LLC Mental Health Current
since Jun 21, 2020
Accepting new patients
Life Solutions Counseling LLC Mental Health Current
since Nov 5, 2023
Accepting new patients

Locations

1410 W Broadway St
Ste 107
Oviedo, FL 32765
Phone (321) 765-4949

7095 Turner Rd
Rockledge, FL 32955
Phone (321) 446-2113

Networks

  • Freedom Health HMO Network

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X I18257 FL Yes

Addresses

Primary practice location

7095 Turner Rd
Rockledge, FL 32955-5728

Mailing address

7095 Turner Rd
Rockledge, FL 32955-5728
Phone (321) 446-2113

Other providers in Rockledge, FL

All providers in Rockledge, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.