Provider Demographics
NPI:1518519321
Name:POLLARD, HEATHER JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:JEAN
Last Name:POLLARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1506
Mailing Address - Country:US
Mailing Address - Phone:207-910-7474
Mailing Address - Fax:207-761-4744
Practice Address - Street 1:12 ELM ST
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1506
Practice Address - Country:US
Practice Address - Phone:207-910-7474
Practice Address - Fax:207-761-4744
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC179101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical