Healthcare Provider Details

I. General information

NPI: 1023165107
Provider Name (Legal Business Name): MOLLY INSOGNA BSW CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOLLY HARTNETT CASAC

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 06/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 GEYSER RD
BALLSTON SPA NY
12020-3022
US

IV. Provider business mailing address

433 GEYSER RD
BALLSTON SPA NY
12020-3022
US

V. Phone/Fax

Practice location:
  • Phone: 518-885-6884
  • Fax: 518-885-0077
Mailing address:
  • Phone: 518-885-6884
  • Fax: 518-885-0077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number19398
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: