Healthcare Provider Details

I. General information

NPI: 1295205573
Provider Name (Legal Business Name): MICHELLE MOLLE-KROWIAK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2018
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 COLUMBIA TPKE STE 202B
FLORHAM PARK NJ
07932-2122
US

IV. Provider business mailing address

17 CRESCENT DR
WHIPPANY NJ
07981-2005
US

V. Phone/Fax

Practice location:
  • Phone: 973-214-2630
  • Fax:
Mailing address:
  • Phone: 973-214-2630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05163100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: