Provider Demographics
NPI:1063561785
Name:POLLACK, MARION (LPC)
Entity type:Individual
Prefix:MS
First Name:MARION
Middle Name:
Last Name:POLLACK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WOODFIELD LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-1064
Mailing Address - Country:US
Mailing Address - Phone:609-896-0025
Mailing Address - Fax:
Practice Address - Street 1:188 TAMARACK CIR
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2021
Practice Address - Country:US
Practice Address - Phone:609-279-1339
Practice Address - Fax:609-279-1359
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00077400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional