Individual
JAMES P POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD LCP
Contact information
Practice address
1100 N GLEBE RD, STE 1010, ARLINGTON, VA 22201-5786
(757) 714-1838
(757) 966-2389
Mailing address
PO BOX 65053, VIRGINIA BEACH, VA 23467-5053
(757) 714-1838
(757) 966-2389
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001848
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
292740
ANTHEM
VA
05
—
7713894
—
VA
Enumeration date
07/17/2006
Last updated
08/21/2023
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