Nicole Pollack, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801085145 Issued in MI

Practice address

30503 Greenfield Rd
Southfield, MI 48076-1594

Phone

(248) 691-4744

NPI assigned

May 23, 2007

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: npollack15806@direct.beaumont.edu

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1437369162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30503 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761594",
            "telephone_number": "248-691-4744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17150 Waterloo St",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe",
            "state": "MI",
            "postal_code": "482301201",
            "country_code": "US",
            "telephone_number": "248-691-4744",
            "fax_number": "248-691-4745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "NICOLE",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "800F329600",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npollack15806@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "30503 Greenfield Rd",
            "city": "Southfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480761594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Juliana Pohl
• Sameer Pokharel
• Loretta Polish, PHD PSYCHOLOGIST
• Michael Polito, DO
• Faith Polk, SWT
• Mitchell Z Pollak, MD
• Kellie Pollard-Rahaming, LPN
• Esther Golda Polter, MSW
• Liba Polter, LMSW
• Yaakov Y Polter, M.S. LLPC

• Clinical Social Worker in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.