MEDICARE: MICHAEL JOSEPH POLLAK PCC,LICDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	E4331	OH

General Provider Information

NPI Number	:	1801965181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOSEPH POLLAK PCC,LICDC

Provider Business Mailing Address
First Line	:	36042 MEADOWDALE DR
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139
Country	:	US
Telephone Number	:	440-349-7787
Fax Number	:

Provider Business Practice Location Address
First Line	:	2770 SOM CENTER RD
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-9111
Country	:	US
Telephone Number	:	440-516-1350
Fax Number	:	440-944-7330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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