Individual provider Active NPI

Katherine Polston

  • Marriage & Family Therapist
  • Gainesville, FL
National Provider Identifier
1245655190
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4548 Issued in FL
Practice address
500 E University Ave Ste C
Gainesville, FL 32601-3458
Phone
(352) 234-3197
NPI assigned
Mar 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT4548 FL Primary

Addresses

Primary practice location

500 E University Ave Ste C
Gainesville, FL 32601-3458

Mailing address

7840 NW 21St Way
Gainesville, FL 32609-5855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251219001952 FL Practitioner - Marriage and Family Therapist 5395230080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 Southpark Blvd
Suite 208
St Augustine, FL 32086-5122

2131 NE 43Rd St
Ocala, FL 34479-2586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT4548FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Growth Sta Marriage & Family Therapist CurrentSince Nov 1, 2025 Accepting new patients
Katherine Polston Counseling, LLC Marriage & Family Therapist Current Accepting new patients

Locations

150 Southpark Blvd
Ste 208
St Augustine, FL 32086
Phone (904) 429-7076

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.

NPI Registry JSON

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1245655190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7840 NW 21ST WAY",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326095855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E UNIVERSITY AVE STE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326013458",
            "telephone_number": "352-234-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSTON",
        "first_name": "KATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-03",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.