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NPI Code Detail

MEDICARE: MOLLY CAITLIN HARTIGAN MA, LPC

MEDICARE: MOLLY CAITLIN HARTIGAN MA, LPC
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
1101YP2500XProfessional Counselor2016045163MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12016045163OTHERMOLPC

General Provider Information

NPI Number : 1215593470
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY CAITLIN HARTIGAN MA, LPC
Provider Business Mailing Address
First Line : 400 N 5TH ST STE 201
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-1808
Country : US
Telephone Number : 636-238-2615
Fax Number : 636-201-3379
Provider Business Practice Location Address
First Line : 400 N 5TH ST STE 201
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-1808
Country : US
Telephone Number : 636-238-2615
Fax Number : 636-201-3379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2019
Last Update Date : 11/20/2023

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