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General NPI Number Information
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NPI Number | 1508502519
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Entity Type | Individual
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Provider Name | GRACE MOLLOY LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 3580 INDIAN QUEEN LN
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1540
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Country | US
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Telephone | 215-995-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 502 W 7TH ST STE 100
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City | ERIE
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State | PA
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Zip | 16502-1333
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Country | US
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Telephone | 215-995-0002
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW022573
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License Number State | PA
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