MEDICARE: JOY DAWN MOLINA LCMHC, LCAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	13279	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-23529	NC

General Provider Information

NPI Number	:	1205355997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY DAWN MOLINA LCMHC, LCAS

Provider Business Mailing Address
First Line	:	599 WATERCREST DR
Second Line	:
City	:	MARION
State	:	NC
Zip	:	28752-8694
Country	:	US
Telephone Number	:	828-357-7425
Fax Number	:

Provider Business Practice Location Address
First Line	:	274 CATAWBA AVE APT D
Second Line	:
City	:	OLD FORT
State	:	NC
Zip	:	28762-8626
Country	:	US
Telephone Number	:	828-357-7425
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2017
Last Update Date	:	01/04/2024

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