Susan Pollack, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW68090 Issued in CA

Practice address

171 Carlos Dr
San Rafael, CA 94903-2005

Phone

(415) 755-2385

NPI assigned

Jan 30, 2017

Last updated

Jan 30, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 18, 2024 through Jan 18, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1316484215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 ASH ST",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 CARLOS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032005",
            "telephone_number": "415-755-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW68090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Plecas, M.F.T.I.
• Lisa Michelle Plopa, M.A.
• Ryan Plumb, MS, AMFT, APCC
• Lisa Marie Polacci, LCSW
• Sarah J Polfliet, M.D.
• Carol H Pollard, PSYD
• Yelena Pomazan
• Pomelo Ca, PC
• Pomelo Ca, PC
• Pomelo Ca, PC

• Social Worker in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.