Individual provider Active NPI

Malka Polonetsky, LMHC

  • Mental Health Counselor
  • Kissimmee, FL
National Provider Identifier
1194555292
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH24231 Issued in FL
Practice address
3201 Zander Dr Apt 302
Kissimmee, FL 34747-1176
Phone
(786) 223-3178
NPI assigned
Aug 3, 2024
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH24231 FL Primary

Addresses

Primary practice location

3201 Zander Dr Apt 302
Kissimmee, FL 34747-1176

Mailing address

615 Burke Rd
Jackson, NJ 08527-4827
Phone (786) 223-3178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260204004135 NJ Practitioner - Mental Health Counselor 4880173368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group NJ PCGroup PAC ID 8224559174, 14 clinicians

Practice addresses (Care Compare)

Hackettstown, NJ 07840
Phone (973) 576-5147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH24231FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group NJ, PC CurrentSince Jan 23, 2026 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1722643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1194555292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 BURKE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274827",
            "telephone_number": "786-223-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 ZANDER DR APT 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347471176",
            "telephone_number": "786-223-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLONETSKY",
        "first_name": "MALKA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-03",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH24231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.