Christina Marie Polk

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

17648 Issued in CT

Practice address

32 Wall St Ste C
Madison, CT 06443-3100

Phone

(203) 245-0412

Fax

(203) 427-0441

NPI assigned

Jul 28, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Toni Kelly Counseling & Consulting

  • Clinical Social Worker
  • Nashville, TN
  • NPI 1093470452
  NPD
• Waterstone Counseling Center, LLC

  • Family Medicine Physician
  • Madison, CT
  • NPI 1851767933

  Clinical

  NPD (past)
• Waterstone Health LLC

  • Family Medicine Physician
  • Madison, CT
  • NPI 1700600053

  Clinical

  NPD (past)

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1457516502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 WALL ST STE C",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433100",
            "telephone_number": "203-245-0412",
            "fax_number": "203-427-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 WALL ST STE C",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433100",
            "telephone_number": "203-245-0412",
            "fax_number": "203-427-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "17648",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "CSW0000007246",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117385",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lee Petersen
• W. Dean Pfeifer, PHD
• Physical Therapy and Wellness Treatment Center, LLC
• Physical Therapy Center of Madison
• Taylor Marie Pisano, LMFT
• Positive Choices Therapy, LLC
• Carol Gray Potter, OTR/L, BCG, CAPS
• Premier Home Health Care Services, Inc
• Priority Health Services LLC
• Lauren Elaine Provini, MD

• Psychiatric/Mental Health Nurse Practitioner in Madison, CT
• Providers in Madison, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.