Ryan Polka, LPCC, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0017909 Issued in CO

Practice address

1217 Riverside Ave
Fort Collins, CO 80524-3218

Phone

(970) 494-4200

NPI assigned

Jul 29, 2015

Sex

Male

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

Enrolled in NV

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

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Nevada HIV Outpatient Program Education and ServicesGroup PAC ID 4385635119, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Northern Nevada HIV Outpatient Program, Education and Services

  • Specialist
  • Reno, NV
  • NPI 1992709976
  Medicare reassignment Care Compare group NPD
• Hope Springs

  • Federally Qualified Health Center (FQHC)
  • Reno, NV
  • NPI 1750901625
  NPD
• Northern Nevada HIV Outpatient Program, Education and Services

  • Federally Qualified Health Center (FQHC)
  • Reno, NV
  • NPI 1659792810
  NPD

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1447635685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR STE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255540",
            "telephone_number": "970-494-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243218",
            "telephone_number": "970-494-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLKA",
        "first_name": "RYAN",
        "credential": "LPCC, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0017909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polaris Partners Counseling and Consulting LLC
• Polaris Partners Counseling and Consulting LLC
• Polaris Partners Counseling and Consulting LLC
• Polaris Partners Counseling and Consulting LLC
• Lara Marie Polce, LPC
• Carly Pollack
• Whitney Raye Pollard
• Leah Pollock, DNP
• Shai Pomeranz
• Flora Pond, BS

• Mental Health Counselor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.