Healthcare Provider Details

I. General information

NPI: 1467908582
Provider Name (Legal Business Name): MOLLY PAPISH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2016
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 WETHERSFIELD AVE
HARTFORD CT
06114-1420
US

IV. Provider business mailing address

331 WETHERSFIELD AVE
HARTFORD CT
06114-1420
US

V. Phone/Fax

Practice location:
  • Phone: 860-236-4511
  • Fax:
Mailing address:
  • Phone: 860-236-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number003319
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number58.010038
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: