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General NPI Number Information
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NPI Number | 1376250266
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Entity Type | Individual
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Provider Name | MOLLY KATE BEEN
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Gender | Female
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 75 NORTH BEACON STREET FL 2
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City | WATERTOWN
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State | MA
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Zip | 02472
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Country | US
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Telephone | 617-850-2093
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Fax |
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Provider Business Mailing Address
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Address Line | 17 UNDERWOOD ST
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City | BELMONT
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State | MA
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Zip | 02478-4021
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Country | US
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Telephone | 479-259-3631
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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