EDWINA DENISE POLK (NPI# 1104486117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104486117 |
| Entity Type | Individual |
| Full Name | EDWINA DENISE POLK |
| Credential | LPC |
| Practice Address |
10130 Mallard Creek Rd Ste 300 Charlotte NC 28262-6001 |
| Mailing Address |
4514 Austin Dekota Dr Charlotte NC 28269-2156 |
| Practice Telephone | 7043208766 |
| Mailing Telephone | 7043208766 |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2019-06-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 11379 | NC | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
11379 | NC | Behavioral Health & Social Service Providers |
| Street Address |
10130 MALLARD CREEK RD STE 300 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-6001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164431136 | Corinna M Costello | Counselor | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2006-08-07 |
| 1386244481 | Creating Change, Pllc | Counselor | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2020-10-28 |
| 1053951236 | Keystone Therapy and Consulting Pllc | Social Worker | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2020-01-15 |
| 1093354391 | Home Care Freedom, LLC | In Home Supportive Care | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2020-01-03 |
| 1679111280 | Karen Rezza | Home Health Aide | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2019-12-13 |
| 1699311340 | Living Legacies Therapeutic Services Pllc | Social Worker | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2019-11-18 |
| 1124663547 | Green Pastures Home Care | In Home Supportive Care | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2019-11-08 |
| 1821647686 | Dontrease Monique Thomas | Counselor | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2019-09-05 |
| 1396223160 | Balanced Mindset Counseling and Psychological Svcs, Pllc | Psychologist | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2018-08-02 |
| 1083137517 | Blissful Counseling & Consulting, Pllc | Clinic/Center | 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262-6001 | 2017-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749324 | Wanda V Jones | Counselor | 11634 Windy Creek Dr Apt H, Charlotte, NC 28262-1923 | 2020-10-28 |
| 1841897667 | Latia Edwards Counseling Services | Counselor | 1224 Kirt Ct, Charlotte, NC 28213-5966 | 2020-10-05 |
| 1932712858 | Antoinette Thornton | Counselor | 2261 Milton Rd, Charlotte, NC 28215-3320 | 2020-08-29 |
| 1457974867 | Boniery Bell | Counselor | 13830 Firenza Cir Apt 202, Charlotte, NC 28273-4426 | 2020-05-20 |
| 1629616982 | Nakina Narkay Scott | Counselor | 5517 River Falls Dr, Charlotte, NC 28215-9674 | 2019-12-18 |
| 1629612981 | Counterstep Counseling and Consulting, Pllc | Counselor | 13534 Plaza Road Ext Ste 114, Charlotte, NC 28215-8921 | 2019-10-30 |
| 1821631193 | Ingrid C Gilbert | Counselor | 6903 Providence Ln W, Charlotte, NC 28226-7751 | 2019-10-19 |
| 1669013041 | Pivotal Health Solutions | Counselor | 15105d John J Delaney Dr Unit 186, Charlotte, NC 28277-2741 | 2019-10-07 |
| 1700447372 | Zachary Ryan Campbell | Counselor | 535 W 7th St Apt 2201, Charlotte, NC 28202-1636 | 2019-06-25 |
| 1366005902 | Mitchell Dwight Smtihbey | Counselor | 8122 Bald Ridge Dr, Charlotte, NC 28227-0316 | 2019-04-18 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.