Healthcare Provider Details

I. General information

NPI: 1679452072
Provider Name (Legal Business Name): MOLLY SCANLON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 17TH ST
VERO BEACH FL
32960-6219
US

IV. Provider business mailing address

11155 ROSELAND RD APT 10
SEBASTIAN FL
32958-8153
US

V. Phone/Fax

Practice location:
  • Phone: 240-899-3111
  • Fax:
Mailing address:
  • Phone: 240-899-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLCM1175
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT5215
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: