Provider Demographics
NPI:1225045875
Name:POLLOCK, GREGORY LEE (PCC, SC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:LEE
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:PCC, SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 2ND ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-2520
Mailing Address - Country:US
Mailing Address - Phone:330-920-9085
Mailing Address - Fax:330-920-9085
Practice Address - Street 1:2321 2ND ST
Practice Address - Street 2:SUITE 108
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-2520
Practice Address - Country:US
Practice Address - Phone:330-920-9085
Practice Address - Fax:330-920-9085
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE3028101Y00000X, 101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)