Provider Demographics
NPI:1235351420
Name:KELLY, MOLLY MELISSA (LSW)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:MELISSA
Last Name:KELLY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:MELISSA
Other - Last Name:HERSHBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:114 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3424
Mailing Address - Country:US
Mailing Address - Phone:614-560-4466
Mailing Address - Fax:
Practice Address - Street 1:114 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3424
Practice Address - Country:US
Practice Address - Phone:419-427-3320
Practice Address - Fax:419-427-1697
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS 0026577104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker