MEDICARE: ALEXANDRA MOLAN LAC

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	101YM0800X	Mental Health Counselor	37AC00741200	NJ

General Provider Information

NPI Number	:	1598570913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA MOLAN LAC

Provider Business Mailing Address
First Line	:	187 WAYNE ST APT 108C
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3393
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	84 WASHINGTON ST STE 3B
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-7504
Country	:	US
Telephone Number	:	551-310-3020
Fax Number	:

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

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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Directions to “ ALEXANDRA MOLAN LAC” Practice Location

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