Healthcare Provider Details

I. General information

NPI: 1033530373
Provider Name (Legal Business Name): ABBY POLLOCK LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2014
Last Update Date: 01/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7105 CROSSROADS BLVD 106
BRENTWOOD TN
37027-2806
US

IV. Provider business mailing address

7105 CROSS ROAD BLVD. 106
BRENTWOOD TN
37027
US

V. Phone/Fax

Practice location:
  • Phone: 615-299-6332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2969
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: