=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992127476
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOLLY SCHOFIELD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2014
-----------------------------------------------------
Last Update Date | 10/17/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1330 BEACON STREET SUITE 263
-----------------------------------------------------
City | BROOKLINE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-355-7549
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 164 CORDAVILLE RD. UNIT 171
-----------------------------------------------------
City | SOUTHBOROUGH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01772-1885
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-460-1635
-----------------------------------------------------
Fax | 857-227-9291
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 116675
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------