Provider Demographics
NPI:1174149413
Name:POLLACK-RINCON, BARBARA (LSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:POLLACK-RINCON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24600 CENTER RIDGE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5650
Mailing Address - Country:US
Mailing Address - Phone:440-508-6928
Mailing Address - Fax:
Practice Address - Street 1:24600 CENTER RIDGE RD STE 220
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5650
Practice Address - Country:US
Practice Address - Phone:440-508-6928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2021-08-03
Deactivation Date:2020-07-20
Deactivation Code:
Reactivation Date:2021-08-03
Provider Licenses
StateLicense IDTaxonomies
OHS.1502315104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker