Collin J. Vander Pol, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003570 Issued in GA

Practice address

81 Crown Mountain PL
Suite a-300
Dahlonega, GA 30533-1627

Phone

(706) 867-0566

Fax

(706) 867-6859

NPI assigned

Sep 20, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Solutions for Growth, Inc.

  • Community/Behavioral Health Agency
  • Dahlonega, GA
  • NPI 1548431299
  Medicare reassignment NPD Authorized official
• PT at Home LLC

  • Physical Therapy Clinic/Center
  • Dahlonega, GA
  • NPI 1346049848
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1922106970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1693",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305330029",
            "telephone_number": "706-867-0566",
            "fax_number": "706-867-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 CROWN MOUNTAIN PL",
            "address_2": "SUITE A-300",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305331627",
            "telephone_number": "706-867-0566",
            "fax_number": "706-867-6859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER POL",
        "first_name": "COLLIN",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "448982378A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "448982378B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• University of North Georgia Research Foundation
• University of Northgeorgia
• Valley View Family Medical Center
• Valley View Medical Center
• Valley View Urgent Care PC
• Mandy Rianna Vander Pol, PT
• Village Podiatry Group, P.C.
• Vista Counseling Services, LLC
• Aaron Wagoner
• Allison Wahl

• Clinical Social Worker in Dahlonega, GA
• Providers in Dahlonega, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.