Provider Demographics
NPI:1023514858
Name:POLLARD, ISHANAE (MACJ, MSW, LSW)
Entity type:Individual
Prefix:
First Name:ISHANAE
Middle Name:
Last Name:POLLARD
Suffix:
Gender:F
Credentials:MACJ, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13301 ROCKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-5167
Mailing Address - Country:US
Mailing Address - Phone:216-832-1547
Mailing Address - Fax:
Practice Address - Street 1:3740 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2532
Practice Address - Country:US
Practice Address - Phone:216-361-9870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health