Healthcare Provider Details

I. General information

NPI: 1396654687
Provider Name (Legal Business Name): HOLLY MOLONEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SHOEMAKER RD
LYNN MA
01904-2233
US

IV. Provider business mailing address

15 SHOEMAKER RD
LYNN MA
01904-2233
US

V. Phone/Fax

Practice location:
  • Phone: 781-820-3360
  • Fax:
Mailing address:
  • Phone: 781-820-3360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLCSW2026011
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: