Provider Demographics
NPI:1477506129
Name:POHRILLE, MARTIN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:
Last Name:POHRILLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 ALTAMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SEA CLIFF
Mailing Address - State:NY
Mailing Address - Zip Code:11579-1403
Mailing Address - Country:US
Mailing Address - Phone:516-674-0438
Mailing Address - Fax:516-674-0255
Practice Address - Street 1:112 FRANKLIN PL
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1253
Practice Address - Country:US
Practice Address - Phone:516-374-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR170951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical