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GINA O'LEARY KIRKLAND POLESETSKY AMFT
NPI 1023698347
Marriage & Family Therapist in Culver City, CA

Active since April 11, 2021Opted out of Medicare · through Jan 8, 2028
9696 CULVER BLVD STE 303, CULVER CITY, CA 90232(323) 362-6468 Get Directions Write a Review

NPPES record last updated: January 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 27, 2023, Apr 11, 2021 (2 updates tracked since 2021).

About Gina O'leary Kirkland Polesetsky Amft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GINA O'LEARY KIRKLAND POLESETSKY AMFT (NPI 1023698347) is an individual marriage & family therapist in Culver City, California, licensed in California (12425) and active in the NPI registry since April 2021. She has opted out of Medicare through January 8, 2028.

NPPES Registry Identity

NPI1023698347
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameGINA O'LEARY KIRKLAND POLESETSKYCredential: AMFT
Location Address9696 CULVER BLVD STE 303Culver City, CA 90232-2759
Mailing Address9696 Culver Blvd Ste 303Culver City, CA 90232-2759 · (323) 362-6468
Phone(323) 362-6468
Sole ProprietorNo
Enumeration DateApril 11, 2021
Last NPPES UpdateJanuary 27, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2023
✔ NPI 1023698347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 12425
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
9696 CULVER BLVD STE 303, Culver City, CA 90232
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Gina O'leary Kirkland Polesetsky Amft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 8, 2024 through January 8, 2028.

Opt-Out Effective DateJanuary 8, 2024
Opt-Out In Effect ThroughJanuary 8, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SARA MICHELE MEHRABANI PSY.D.
Psychologist (Clinical)
9696 CULVER BLVD STE 303
CULVER CITY, CA 90232
Los Angeles County (323) 909-9263
RECOVERY MARRIAGE AND FAMILY COUNSELING INC
Clinic/Center (Mental Health (Including Community Mental Health Center))
9696 CULVER BLVD STE 303
CULVER CITY, CA 90232
Los Angeles County (323) 723-2674
ANGELA BRAVER LCSW MFT
Social Worker (Clinical)
9696 CULVER BLVD STE 303
CULVER CITY, CA 90232
Los Angeles County (818) 762-3200
YASMIN VISHRAM-MORRIS MFT
Marriage & Family Therapist
9696 CULVER BLVD STE 303
CULVER CITY, CA 90232
Los Angeles County (424) 750-5835
SEA CHANGE MENTAL HEALTH AND PSYCHOTHERAPY INC.
Psychologist (Clinical)
9696 CULVER BLVD STE 303
CULVER CITY, CA 90232
Los Angeles County (323) 909-9263
DR. NATHANIEL THOMAS PH.D
Psychologist (Clinical)
9696 CULVER BLVD STE 303
CULVER CITY, CA 90232
Los Angeles County (323) 971-1405
LACEY SIMONE BOOKSPAN AMFT, APCC
Counselor (Professional)
9696 CULVER BLVD STE 303
CULVER CITY, CA 90232
Los Angeles County (424) 235-0209
DR. ERIN KUNTZE PSY.D.
Psychologist (Clinical)
9696 CULVER BLVD STE 303
CULVER CITY, CA 90232
Los Angeles County (424) 259-3832

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gina Polesetsky's NPI number?

The NPI number for Gina Polesetsky is 1023698347. It was assigned to this individual provider in the NPPES registry on April 11, 2021.

Where is Gina Polesetsky located?

Gina Polesetsky practices at 9696 Culver Blvd Ste 303, Culver City, CA 90232. The listed phone number is (323) 362-6468.

What is Gina Polesetsky's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Gina Polesetsky enrolled in Medicare?

No. Gina Polesetsky has opted out of Medicare through January 8, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Gina Polesetsky was last updated on January 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.