Healthcare Provider Details

I. General information

NPI: 1457201527
Provider Name (Legal Business Name): ERIC MOLL LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25A HANOVER RD STE 120
FLORHAM PARK NJ
07932-1445
US

IV. Provider business mailing address

228 N 10TH ST FL 1
KENILWORTH NJ
07033-1152
US

V. Phone/Fax

Practice location:
  • Phone: 973-718-5552
  • Fax:
Mailing address:
  • Phone: 973-718-5552
  • Fax: 973-860-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00349100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: