Provider Demographics
NPI:1972838506
Name:POLLARO, SANDRA (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:POLLARO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 FARR LN
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1989
Mailing Address - Country:US
Mailing Address - Phone:518-793-0792
Mailing Address - Fax:
Practice Address - Street 1:1153 BURGOYNE AVENUE
Practice Address - Street 2:HUDSON FALLS CENTRAL SCHOOL DISTRICT
Practice Address - City:FORT EDWARD
Practice Address - State:NY
Practice Address - Zip Code:12828
Practice Address - Country:US
Practice Address - Phone:518-747-2121
Practice Address - Fax:518-747-0951
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0763301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical