Carly Pollock

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

093777 Issued in IA

Practice address

3251 W 9TH St
Waterloo, IA 50702-5310

Phone

(319) 234-2893

NPI assigned

Sep 6, 2019

Last updated

Sep 6, 2019By 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

Other identifiers 1

Other names 1

• Carly Russell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carly.pollock@unitypoint.org

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.

• Team Together Mental Health Counseling, PLLC

  • Mental Health Counselor
  • Parkersburg, IA
  • NPI 1134018294
  Medicare reassignment NPD Authorized official
• Black Hawk-Grundy Mental Health Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterloo, IA
  • NPI 1316944598
  NPD

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1912556408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3251 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025310",
            "telephone_number": "319-234-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025310",
            "telephone_number": "319-234-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "093777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074435",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Carly.Pollock@unitypoint.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "address_1": "3251 W 9th St",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507025310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "RUSSELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shawn Thomas Plunkett, ARNP
• PM Acquisition, LLC (Medicap Pharmacy LTC Waterloo)
• Caitlin Anne Podemski, MT-BC
• Point Health Centers of America, Inc
• Yadunath Pokharel, MD
• Vara Venkata Padma Kamala Kumari Ponnada, MD
• James Joseph Poock, MD
• Vijayasimha Reddy Pothula, MD
• Ronald L Potter
• Potter's Hearing Aid Service

• Mental Health Counselor in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.