Provider Demographics
NPI:1851643902
Name:POLLOCK, MELISSA QUINN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:QUINN
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:QUINN
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14433 RANGE PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-3112
Mailing Address - Country:US
Mailing Address - Phone:312-217-6885
Mailing Address - Fax:
Practice Address - Street 1:14433 RANGE PARK ROAD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-3112
Practice Address - Country:US
Practice Address - Phone:312-217-6885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CALCSW767071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program