Alissa Beth Polley, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

164521239 Issued in UT

Practice address

11075 S State St Ste 28
Sandy, UT 84070-5176

Phone

(801) 501-8444

Fax

(801) 733-4083

NPI assigned

Sep 28, 2011

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• C Hakes LLC

  • Community/Behavioral Health Agency
  • Tooele, UT
  • NPI 1487191581
  NPD (past)

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1972887750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 900245",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840900245",
            "telephone_number": "801-634-8727",
            "fax_number": "801-733-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 28",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705176",
            "telephone_number": "801-501-8444",
            "fax_number": "801-733-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLEY",
        "first_name": "ALISSA",
        "middle_name": "BETH",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "164521239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica J Pochmara, RD
• Danny Poleki
• Tusi Poleki
• Ashley Marie Polidori, LCSW
• Roberta Polkinghorn, MA, CMHC, LPC, CPC,
• Megan Ashley Pond-Maxwell, AMFT
• Janis M Pope, APRN
• Kael McCade Pope, L.C.S.W.
• Iris Popescu, BCBA
• Robin Scott Poppen, MD

• Clinical Social Worker in Sandy, UT
• Providers in Sandy, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.