Healthcare Provider Details

I. General information

NPI: 1598678542
Provider Name (Legal Business Name): CREATIVE ELEMENTS HEALTH & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR STE 11579
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

8401 MAYLAND DR STE 11579
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 202-930-1722
  • Fax:
Mailing address:
  • Phone: 202-930-1722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CARLY POLOSKEY
Title or Position: OWNER
Credential: LMHC, MT-BC
Phone: 561-213-1682