Individual provider Active NPI

Paul Afanasi Polanski, LCSW

  • Clinical Social Worker
  • Fargo, ND
National Provider Identifier
1376151597
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5384 Issued in ND
Practice address
3285 Fiechtner Dr S Ste B
Fargo, ND 58103-2490
Phone
(701) 630-8813
Fax
(701) 425-0448
NPI assigned
Jul 14, 2020
Last updated
May 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5384 ND Primary

Addresses

Primary practice location

3285 Fiechtner Dr S Ste B
Fargo, ND 58103-2490

Mailing address

3285 Fiechtner Dr S Ste B
Fargo, ND 58103-2490
Phone (701) 630-8813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20210914001247 ND Practitioner - Clinical Social Worker 5294131595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3285 Fiechtner Dr S
Suite 2
Fargo, ND 58103-2488
Phone (701) 630-8813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5384NDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ronin Counseling Clinical CurrentSince Jul 27, 2021 Accepting new patients

Locations

3217 Fiechtner Dr S
Ste C
Fargo, ND 58103

3285 Fiechtner Dr S
Ste 2
Fargo, ND 58103
Phone (701) 630-8813

3285 Fiechtner Dr S
Ste B
Fargo, ND 58103
Phone (701) 361-8273

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1376151597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 FIECHTNER DR S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032490",
            "telephone_number": "701-630-8813",
            "fax_number": "701-425-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 FIECHTNER DR S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032490",
            "telephone_number": "701-630-8813",
            "fax_number": "701-425-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANSKI",
        "first_name": "PAUL",
        "middle_name": "AFANASI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "5384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.