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General NPI Number Information
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NPI Number | 1518330232
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Entity Type | Individual
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Provider Name | MOLLY ANSARI LCPC
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Gender | Female
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Dates
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Enumeration Date | 11/03/2015
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 29W170 BUTTERFIELD RD STE 103
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City | WARRENVILLE
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State | IL
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Zip | 60555-2807
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Country | US
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Telephone | 331-465-1153
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Fax |
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Provider Business Mailing Address
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Address Line | 854 SEMINARY CIR
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City | GLEN ELLYN
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State | IL
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Zip | 60137-6158
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Country | US
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Telephone | 920-698-1886
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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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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1800009952
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.009952
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License Number State | IL
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