MEDICARE: MS. MOLLY LYTTON LMFT

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	106H00000X	Marriage & Family Therapist	MFT 17447	CA
2	106H00000X	Marriage & Family Therapist	MFT 92	HI

General Provider Information

NPI Number	:	1417225236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MOLLY LYTTON LMFT

Provider Business Mailing Address
First Line	:	615 PIIKOI ST STE 1406
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3141
Country	:	US
Telephone Number	:	808-253-8786
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 PIIKOI ST STE 1406
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3141
Country	:	US
Telephone Number	:	808-369-3823
Fax Number	:

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

Provider Enumeration Date	:	12/07/2011
Last Update Date	:	02/13/2019

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