Provider Demographics
NPI:1447735675
Name:POLLICK, TIA (LMHCA)
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:
Last Name:POLLICK
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:TIA
Other - Middle Name:
Other - Last Name:BARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 285
Mailing Address - Street 2:
Mailing Address - City:NORTH LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98259-0285
Mailing Address - Country:US
Mailing Address - Phone:425-512-3162
Mailing Address - Fax:
Practice Address - Street 1:8018 CARLISLE PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-5069
Practice Address - Country:US
Practice Address - Phone:425-512-3162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60976910101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health