Provider Demographics
NPI:1578625109
Name:SALANS, MOLLY SUSAN (LICSW, LMFT)
Entity Type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:SUSAN
Last Name:SALANS
Suffix:
Gender:F
Credentials:LICSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 KING ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1279
Mailing Address - Country:US
Mailing Address - Phone:978-742-5999
Mailing Address - Fax:978-952-6336
Practice Address - Street 1:531 KING ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1279
Practice Address - Country:US
Practice Address - Phone:978-742-5999
Practice Address - Fax:978-952-6336
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1025615101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22964Medicare PIN