Provider Demographics
NPI:1396361812
Name:POLLOCK, BENJAMIN (LMFT)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1437 S BELCHER RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-2829
Mailing Address - Country:US
Mailing Address - Phone:172-752-4446
Mailing Address - Fax:727-538-7272
Practice Address - Street 1:1437 S BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-2829
Practice Address - Country:US
Practice Address - Phone:172-752-4446
Practice Address - Fax:727-538-7272
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-20
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3837106H00000X
FLMH18251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist