Healthcare Provider Details

I. General information

NPI: 1174149413
Provider Name (Legal Business Name): BARBARA POLLACK-RINCON LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date: 07/20/2020
Reactivation Date: 08/03/2021

III. Provider practice location address

24600 CENTER RIDGE RD STE 220
WESTLAKE OH
44145-5650
US

IV. Provider business mailing address

24600 CENTER RIDGE RD STE 220
WESTLAKE OH
44145-5650
US

V. Phone/Fax

Practice location:
  • Phone: 440-508-6928
  • Fax:
Mailing address:
  • Phone: 440-508-6928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.1502315
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: