Healthcare Provider Details

I. General information

NPI: 1891344487
Provider Name (Legal Business Name): VICTORIA MORGAN POLLARD MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA ROTHMAN MSW, LCSW

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 SLEEPY FAWN PARK
COLUMBUS MS
39702-7843
US

IV. Provider business mailing address

164 SLEEPY FAWN PARK
COLUMBUS MS
39702-7843
US

V. Phone/Fax

Practice location:
  • Phone: 973-590-1045
  • Fax:
Mailing address:
  • Phone: 973-590-1045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP015071
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC12114
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: