Elizabeth Polen, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC-222490 Issued in AZ

Practice address

1209 S 1St Ave
Phoenix, AZ 85003-2692

Phone

(602) 258-6797

NPI assigned

Oct 2, 2023

Last updated

Oct 2, 2023By the provider in NPPES

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

Enrolled in AZ

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wesley Community Center IncGroup PAC ID 9032264239, 14 clinicians

Practice addresses (Care Compare)

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

• Wesley Community Center Inc

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1396910436
  Medicare reassignment Care Compare group NPD
• Wesley Community Center, Inc

  dba Wesley Community & Health Centers

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1699431726
  NPD
• Four Corners Counseling and Wellness Inc.

  • Mental Health Counselor
  • Phoenix, AZ
  • NPI 1487306296
  NPD (past)

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1619757424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 S 1ST AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850032692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 S 1ST AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850032692",
            "telephone_number": "602-258-6797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 N 32nd St Ste 201J",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850180003",
            "country_code": "US",
            "telephone_number": "602-922-6456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLEN",
        "first_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LPC-222490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlene Polakof, DPM
• Michael Ervin Polakowski
• Joan Marie Polansky, PH.D.
• Polaris Medical Group LLC
• Delia Mae Poleahla, RN.
• Jack Nathan Poles, M.D.
• Sharon L Polintan, P.T.
• Polite Canoe Therapy and Wellness, PLLC
• Eugenia G. Politis, M.D.
• Samantha A Polito, AG-ACNP

• Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.