Roberta Polkinghorn, MA, CMHC, LPC, CPC,

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10728504-6004 Issued in UT

Practice address

1553 E Owenwood Cir
Sandy, UT 84092-5381

Phone

(801) 518-3554

NPI assigned

Sep 7, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in UT

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Harmony Station Counseling LLC

  • Adult Mental Health Clinic/Center
  • Sandy, UT
  • NPI 1619715174
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1410048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1740681964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 E OWENWOOD CIR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840925381",
            "telephone_number": "801-518-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 E OWENWOOD CIR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840925381",
            "telephone_number": "801-518-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLKINGHORN",
        "first_name": "ROBERTA",
        "name_prefix": "Ms.",
        "credential": "MA, CMHC, LPC, CPC,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-07",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10728504-6004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "0701011742",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCC",
            "identifier": "267724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMHC",
            "identifier": "10728504-6004",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CPC",
            "identifier": "CP5288-R",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Platinum Venture Group LLC
• Jessica J Pochmara, RD
• Danny Poleki
• Tusi Poleki
• Ashley Marie Polidori, LCSW
• Alissa Beth Polley, CSW
• Megan Ashley Pond-Maxwell, AMFT
• Janis M Pope, APRN
• Kael McCade Pope, L.C.S.W.
• Iris Popescu, BCBA

• Mental Health Counselor in Sandy, UT
• Providers in Sandy, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.