Active NPI
Carol Ann Polevoi, M.A. M.F.T.
- Marriage & Family Therapist
- Encino, CA
National Provider Identifier
1154407161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 32105
- Practice address
- 16055 Ventura Blvd Ste 717
Encino, CA 91436-2610 - Phone
- (818) 889-3905
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 32105 | CA | Primary |
Addresses
Primary practice location
16055 Ventura Blvd Ste 717
Encino, CA 91436-2610
Mailing address
4930 Balboa Blvd Unit 260734
Encino, CA 91426-7037
Phone (818) 889-3905
Other practice location 1
5923 Kanan Rd
Agoura Hills, CA 91301-1688
Phone (818) 889-3905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32105 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carol a. Polevoi, LMFT/Wellness Coach, Apc | Marriage & Family Therapist | Current | Accepting new patients |
Locations
4930 Balboa Blvd
Unit 260734
Encino, CA 91426
16055 Ventura Blvd
Ste 717
Encino, CA 91436
Phone (818) 215-0367
Organizations & group practices 1
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.
-
- Marriage & Family Therapist
- Encino, CA
- NPI 1366006645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540166400000",
"number": "1154407161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4930 BALBOA BLVD UNIT 260734",
"city": "ENCINO",
"state": "CA",
"postal_code": "914267037",
"telephone_number": "818-889-3905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16055 VENTURA BLVD STE 717",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362610",
"telephone_number": "818-889-3905"
}
],
"practiceLocations": [
{
"address_1": "5923 Kanan Rd",
"address_purpose": "LOCATION",
"city": "Agoura Hills",
"state": "CA",
"postal_code": "913011688",
"country_code": "US",
"telephone_number": "818-889-3905",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLEVOI",
"first_name": "CAROL",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "M.A. M.F.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2018-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "32105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.