Healthcare Provider Details

I. General information

NPI: 1437667987
Provider Name (Legal Business Name): NILERISHA MOLLETTE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NILERISHA MOLLETTE LCSW

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E MAIN ST STE 105
MIDDLETOWN NY
10940-4038
US

IV. Provider business mailing address

60 HUDSON CIR
MARLBORO NY
12542-6189
US

V. Phone/Fax

Practice location:
  • Phone: 845-513-3070
  • Fax:
Mailing address:
  • Phone: 917-565-0614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101485
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: