Provider Demographics
NPI:1497771133
Name:MOLITOR, PATRICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MOLITOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 SE MAYNARD RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6945
Mailing Address - Country:US
Mailing Address - Phone:919-467-7667
Mailing Address - Fax:919-467-7667
Practice Address - Street 1:1230 SE MAYNARD RD
Practice Address - Street 2:SUITE 204
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6945
Practice Address - Country:US
Practice Address - Phone:919-467-7667
Practice Address - Fax:919-467-7667
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0027841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3045876OtherAETNA
NC1156UOtherBLUE CROSS/BLUE SHIELD
NC1156UOtherNC HEALTHCHOICE
NCA850780OtherVALUE OPTIONS
NC9264218OtherPHCS BEHAVIORAL
NC0001128295OtherMANAGED HEALTH NETWORK
NC6002441Medicaid
NC1161531OtherCIGNA BEHAVIORAL HEALTH
NCA7924OtherMEDCOST
NC1156UOtherNC HEALTHCHOICE