Healthcare Provider Details

I. General information

NPI: 1982006706
Provider Name (Legal Business Name): POLLARD COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2014
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 BURKESVILLE ST SUITE 111
COLUMBIA KY
42728-1900
US

IV. Provider business mailing address

203 BURKESVILLE ST SUITE 111
COLUMBIA KY
42728-1900
US

V. Phone/Fax

Practice location:
  • Phone: 270-384-1198
  • Fax: 270-384-1195
Mailing address:
  • Phone: 270-384-1198
  • Fax: 270-384-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0453
License Number StateKY

VIII. Authorized Official

Name: MRS. MELODY J POLLARD
Title or Position: OWNER/PROVIDER
Credential: LPCC
Phone: 270-384-1198