Samuel Harris Pond, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11747219-3501 Issued in UT

Practice address

2027 N 200 E
North Logan, UT 84341-5505

Phone

(435) 764-6312

NPI assigned

Mar 30, 2017

Sex

Male

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 UT

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Green Canyon Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Logan, UT
  • NPI 1437885266
  Medicare reassignment NPD Authorized official
• Quality Youth Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Harrisville, UT
  • NPI 1023335890
  NPD (past)

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1285166108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 N 200 E",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843415505",
            "telephone_number": "435-764-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2027 N 200 E",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843415505",
            "telephone_number": "435-764-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POND",
        "first_name": "SAMUEL",
        "middle_name": "HARRIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11747219-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan J. Perry, D.P.T.
• Shaun M Petersen, PA
• Phil Rich Inc
• Philrich Inc
• Philrich Inc
• Bryan Neal Porter, D.D.S.
• Primary Care Pediatrics
• Jeffrey J Pulley, PA-C
• Robert S. Cook, PH.D., PC
• Glenn L Robertson, MD

• Clinical Social Worker in North Logan, UT
• Providers in North Logan, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.