Healthcare Provider Details

I. General information

NPI: 1336335637
Provider Name (Legal Business Name): JOSEPH Z MOLINARI LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 07/20/2024
Certification Date: 07/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 W ALAMEDA ST APT 33
SANTA FE NM
87507-9081
US

IV. Provider business mailing address

2180 W ALAMEDA ST APT 18
SANTA FE NM
87507-9081
US

V. Phone/Fax

Practice location:
  • Phone: 571-253-1433
  • Fax:
Mailing address:
  • Phone: 571-253-1433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25255
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09923746
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: