Provider Demographics
NPI:1699944405
Name:POLLOCK, JAMALL (LMSW)
Entity type:Individual
Prefix:MR
First Name:JAMALL
Middle Name:
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2279 3RD AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2249
Mailing Address - Country:US
Mailing Address - Phone:646-273-8139
Mailing Address - Fax:
Practice Address - Street 1:2279 3RD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2249
Practice Address - Country:US
Practice Address - Phone:646-273-8139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078164-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker