Provider Demographics
NPI:1306181987
Name:POLLAS, RACHELLE
Entity Type:Individual
Prefix:MISS
First Name:RACHELLE
Middle Name:
Last Name:POLLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6204
Mailing Address - Country:US
Mailing Address - Phone:718-237-8833
Mailing Address - Fax:718-237-9113
Practice Address - Street 1:500 19TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6204
Practice Address - Country:US
Practice Address - Phone:718-237-8833
Practice Address - Fax:718-237-9113
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY634062101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool