Poling Chan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

992606 Issued in CO

Practice address

504 S College Ave
Suite D
Fort Collins, CO 80524-3002

Phone

(970) 481-7397

Fax

(970) 226-6103

NPI assigned

Jan 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Washington University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Poudre Valley Health Care,Inc

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1891837738
  NPD (past)
• Transform the Nest

  • Clinical Social Worker
  • Fort Collins, CO
  • NPI 1215561857
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245389618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 OVERLOOK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805263335",
            "telephone_number": "970-226-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S COLLEGE AVE",
            "address_2": "SUITE D",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243002",
            "telephone_number": "970-481-7397",
            "fax_number": "970-226-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "POLING",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "992606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Chamberlin, RDH
• Bobbi J Chambers, MD
• Jill Chambers
• Maggie S Champion, MSN, FNP-BC
• Thomas J Champion, PT, DPT
• Venkataperumal R Chandrasekaran, MD
• Yu-Hsin Chang
• Flor Chaparro
• Ashley Nicole Chapman, PTA
• Jeffrey K Chapman, MD

• Clinical Social Worker in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.