MEDICARE: WENDY MOLITOR LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2106044211	MO
2	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053827915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY MOLITOR LPC

Provider Business Mailing Address
First Line	:	400 HIGHWAY 87
Second Line	:
City	:	ELDON
State	:	MO
Zip	:	65026-4040
Country	:	US
Telephone Number	:	573-280-4933
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 N PROVIDENCE RD STE 327
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65202-3710
Country	:	US
Telephone Number	:	573-280-4933
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2017
Last Update Date	:	03/03/2022

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Directions to “ WENDY MOLITOR LPC” Practice Location

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