Provider Demographics
NPI:1104102516
Name:POLLOCK, MEGAN B (LPC-S, CST)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:B
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:LPC-S, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 WEST LOOP S STE 410
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2406
Mailing Address - Country:US
Mailing Address - Phone:832-724-4477
Mailing Address - Fax:832-201-9271
Practice Address - Street 1:5959 WEST LOOP S STE 410
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2406
Practice Address - Country:US
Practice Address - Phone:281-974-2726
Practice Address - Fax:832-201-9271
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-30
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18400OtherLICENSED PROFESSIONAL COUNSELOR - SUPERVISOR