Provider Demographics
NPI:1245560523
Name:MOLLOY, JESSICA FRANCES (MA, LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:FRANCES
Last Name:MOLLOY
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 HANOVER ST
Mailing Address - Street 2:PO BOX 448
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2203
Mailing Address - Country:US
Mailing Address - Phone:603-518-4000
Mailing Address - Fax:603-668-6260
Practice Address - Street 1:99 HANOVER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2203
Practice Address - Country:US
Practice Address - Phone:603-518-4000
Practice Address - Fax:603-668-6260
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH781101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health