Provider Demographics
NPI:1235533811
Name:MOLLIE SOKOLOV LCSW
Entity Type:Organization
Organization Name:MOLLIE SOKOLOV LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MOLLIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SOKOLOV
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-819-2348
Mailing Address - Street 1:134 MAIN ST
Mailing Address - Street 2:SUITE # 2A
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1128
Mailing Address - Country:US
Mailing Address - Phone:914-819-2348
Mailing Address - Fax:
Practice Address - Street 1:134 MAIN ST
Practice Address - Street 2:SUITE # 2A
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1128
Practice Address - Country:US
Practice Address - Phone:914-819-2348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0291141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty