Provider Demographics
NPI:1063116903
Name:POLLARD, TRAVIS (MA, LPC, EMDR)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:POLLARD
Suffix:
Gender:M
Credentials:MA, LPC, EMDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 LAKE VILLA DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-635-7162
Mailing Address - Fax:
Practice Address - Street 1:2750 LAKE VILLA DR
Practice Address - Street 2:SUITE 301
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-635-7162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional