Active NPI
Carly Pollack
- Clinical Social Worker
- Fort Collins, CO
National Provider Identifier
1073107520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 2260 W Trilby Rd
Fort Collins, CO 80526-9650 - Phone
- (970) 494-4200
- NPI assigned
- Feb 25, 2021
- Reactivated
- Apr 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
2260 W Trilby Rd
Fort Collins, CO 80526-9650
Mailing address
4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone (970) 494-4200
Other practice location 1
390 40th St
Oakland, CA 94609-2633
Phone (510) 613-0330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1073107520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4856 INNOVATION DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255539",
"telephone_number": "970-494-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2260 W TRILBY RD",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805269650",
"telephone_number": "970-494-4200"
}
],
"practiceLocations": [
{
"address_1": "390 40th St",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946092633",
"country_code": "US",
"telephone_number": "510-613-0330",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLLACK",
"first_name": "CARLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-25",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"deactivation_date": "2023-03-03",
"reactivation_date": "2023-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.