Provider Demographics
NPI:1316001068
Name:POLLARD, COLLEEN SCHLENKE (LCSW)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:SCHLENKE
Last Name:POLLARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:MARY
Other - Last Name:SCHLENKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 21272
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0129
Mailing Address - Country:US
Mailing Address - Phone:404-668-3340
Mailing Address - Fax:
Practice Address - Street 1:5060 VALLEY VIEW BLVD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-2038
Practice Address - Country:US
Practice Address - Phone:540-278-1051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0037911041C0700X
VA09040079321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical