Nicole Christine Polan, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801116072 Issued in MI

Practice address

5340 Plymouth Rd Ste 110
Ann Arbor, MI 48105-9558

Phone

(734) 335-4747

NPI assigned

Nov 9, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Polan Therapeutic Services PLLC

  • Clinical Social Worker
  • Ann Arbor, MI
  • NPI 1861349680
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1053784348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 PLYMOUTH RD STE 110",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059558",
            "telephone_number": "734-335-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 PLYMOUTH RD STE 110",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059558",
            "telephone_number": "734-335-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAN",
        "first_name": "NICOLE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802088716",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801116072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie K Poisson, NP
• Brianna Poitevint
• David Ryan Pokorny, MD
• Elena Lauren Pokowitz, M.ED., TLLP
• Polan Therapeutic Services PLLC
• Stephen P Polanski, MD
• Matthew Dane Polasko, MD
• Ann Marie Polcari, MD, MPH, MS
• Nnamdi Pole, PH.D.
• Caitlyn Polhill

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.