Individual provider Active NPI

Polly Paccassi Lund, MSW, CSW-I

  • Social Worker
  • Sierra Vista, AZ
National Provider Identifier
1851018147
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
12957061-3506 Issued in AZ
Practice address
155 Calle Portal Ste 700
Sierra Vista, AZ 85635-2973
Phone
(520) 364-1429
Fax
(520) 515-8690
NPI assigned
Oct 26, 2022
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 12957061-3506 AZ Primary

Addresses

Primary practice location

155 Calle Portal Ste 700
Sierra Vista, AZ 85635-2973

Mailing address

1205 N F Ave
Douglas, AZ 85607-1920
Phone (520) 364-1429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241021001879 UT Practitioner - Clinical Social Worker 8729510375 Reassigns benefits to 1 organization
I20250922003396 AZ Practitioner - Clinical Social Worker 8729510375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

155 Calle Portal
Sierra Vista, AZ 85635-2900
Phone (520) 459-3012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12957061-3506AZMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chiricahua Community Health Centers, Inc. CurrentSince Aug 11, 2025 Accepting new patients
Bear River Mental Health Services Inc CurrentSince Sep 12, 2024 Accepting new patients
Chiricahua Community Health Centers, Inc CurrentSince Aug 11, 2025 Accepting new patients

Locations

1205 N F Ave
Douglas, AZ 85607
Phone (520) 364-6852

10566 N Highway 191
Elfrida, AZ 85610
Phone (520) 642-2222

155 Calle Portal
Ste 700
Sierra Vista, AZ 85635
Phone (520) 459-0203

663 W Hospital Rd
Brigham City, UT 84302
Phone (435) 734-9449

90 E 200 N
Logan, UT 84321
Phone (435) 752-0750

Interoperability endpoints

  • Direct secure messaging: polly.lund.p1@direct.cchci.nextgenshare.com

Organizations & group practices 3

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": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1851018147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-1429",
            "fax_number": "520-515-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CALLE PORTAL STE 700",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352973",
            "telephone_number": "520-364-1429",
            "fax_number": "520-515-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUND",
        "first_name": "POLLY",
        "middle_name": "PACCASSI",
        "credential": "MSW, CSW-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "12957061-3506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.