MEDICARE: MR. JOHN MICHAEL POLI LMHC, CAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH 6406	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	Z128R	OTHER	FL	BCBSF PROVIDER NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215947155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN MICHAEL POLI LMHC, CAP

Provider Business Mailing Address
First Line	:	405 SE GASPARILLA AVENUE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983
Country	:	US
Telephone Number	:	772-285-5445
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 SE HILLMOOR DR STE 201
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-8057
Country	:	US
Telephone Number	:	722-285-5445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	08/27/2025

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