Individual provider Active NPI

Lynn Pollock, M.A.

  • Mental Health Counselor
  • Waltham, MA
National Provider Identifier
1093023699
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8343 Issued in MA
Practice address
1430 Main St
Waltham, MA 02451-1623
Phone
(781) 647-5327
NPI assigned
Sep 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 8343 MA Primary

Addresses

Primary practice location

1430 Main St
Waltham, MA 02451-1623

Mailing address

1430 Main St
Waltham, MA 02451-1623
Phone (781) 647-5327

Other practice location 1

172 Lincoln St
Worcester, MA 01605-3750
Phone (508) 770-0511 ext. 126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 30, 2025 through Jan 30, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
8343MAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093023699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511623",
            "telephone_number": "781-647-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511623",
            "telephone_number": "781-647-5327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "172 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016053750",
            "country_code": "US",
            "telephone_number": "508-770-0511 x126",
            "fax_number": "508-770-0875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "8343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.