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General NPI Number Information
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NPI Number | 1215947155
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Entity Type | Individual
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Provider Name | JOHN MICHAEL POLI LMHC, CAP
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 2100 SE HILLMOOR DR STE 201
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-8057
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Country | US
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Telephone | 722-285-5445
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Fax |
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Provider Business Mailing Address
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Address Line | 405 SE GASPARILLA AVENUE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983
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Country | US
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Telephone | 772-285-5445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 6406
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License Number State | FL
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