Provider Demographics
NPI:1629575931
Name:MEGAN POLLOCK THERAPY
Entity Type:Organization
Organization Name:MEGAN POLLOCK THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:POLLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, CST
Authorized Official - Phone:281-974-2726
Mailing Address - Street 1:5959 WEST LOOP S STE 410
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2406
Mailing Address - Country:US
Mailing Address - Phone:281-974-2726
Mailing Address - Fax:832-201-9271
Practice Address - Street 1:5959 WEST LOOP S STE 410
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2406
Practice Address - Country:US
Practice Address - Phone:281-974-2726
Practice Address - Fax:832-201-9271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18400OtherLICENSED PROFESSIONAL COUNSELOR - SUPERVISOR