Kelsey Carin Polk, AMFT/APCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT149539 Issued in CA

Practice address

222 S Hill St Ste 600
Los Angeles, CA 90012-3523

Phone

(213) 255-9753

NPI assigned

Sep 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1275369902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE STE 2B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "310-221-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S HILL ST STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123523",
            "telephone_number": "213-255-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "KELSEY",
        "middle_name": "CARIN",
        "credential": "AMFT/APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT149539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delores Genise Polite
• Dorothy M. Polite
• Iia Poliuliak
• Alicea Polk
• Julia Rose M. Polk, LMFT
• Richard Polk, RADT
• Shantell Monique Polk, M.A.
• Sarah Polkinghorn, CRNA
• Tracy Alexandra Pollack, PSYD
• Jasmine Pollak

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.