Healthcare Provider Details

I. General information

NPI: 1144954587
Provider Name (Legal Business Name): MOLLY GUERRANT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 SADLER PL STE 201
GLEN ALLEN VA
23060-6146
US

IV. Provider business mailing address

5030 SADLER PL STE 201
GLEN ALLEN VA
23060-6146
US

V. Phone/Fax

Practice location:
  • Phone: 804-214-7662
  • Fax:
Mailing address:
  • Phone: 804-214-7662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number070101159
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: