Provider Demographics
NPI:1255870085
Name:POLLARD, TRULY (LPC)
Entity Type:Individual
Prefix:
First Name:TRULY
Middle Name:
Last Name:POLLARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18125 HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:AL
Mailing Address - Zip Code:36560-6415
Mailing Address - Country:US
Mailing Address - Phone:251-545-6398
Mailing Address - Fax:
Practice Address - Street 1:18125 HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:AL
Practice Address - Zip Code:36560
Practice Address - Country:US
Practice Address - Phone:251-545-6398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3669101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional