Organization Active NPI

Polaris Therapy Group

  • Mental Health Counselor
  • Lexington, KY
National Provider Identifier
1124907159
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
POLARIS THERAPY GROUP
Practice address
1550 Trent Blvd Apt 605
Lexington, KY 40515-1908
Phone
(859) 797-7371
NPI assigned
Sep 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
John Wesley
Title
Owner
Phone
(859) 797-7371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1550 Trent Blvd Apt 605
Lexington, KY 40515-1908

Mailing address

1550 Trent Blvd Apt 605
Lexington, KY 40515-1908
Phone (859) 797-7371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260102002927 KY Part B Supplier - Clinic/Group Practice 4486140068 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1124907159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 TRENT BLVD APT 605",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405151908",
            "telephone_number": "859-797-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 TRENT BLVD APT 605",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405151908",
            "telephone_number": "859-797-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "WESLEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-797-7371"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.