Provider Demographics
NPI:1518052786
Name:POLLACK, PAMELA LYNN (LCSW, LISW)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LYNN
Last Name:POLLACK
Suffix:
Gender:F
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20191 E COUNTRY CLUB DR
Mailing Address - Street 2:#904
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3012
Mailing Address - Country:US
Mailing Address - Phone:305-542-3479
Mailing Address - Fax:
Practice Address - Street 1:20191 E COUNTRY CLUB DR
Practice Address - Street 2:#904
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3012
Practice Address - Country:US
Practice Address - Phone:305-542-3479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW25351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical