Provider Demographics
NPI:1639606627
Name:WESTFALL, MOLLY
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:WESTFALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S RIVER ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-5185
Mailing Address - Country:US
Mailing Address - Phone:630-844-2662
Mailing Address - Fax:630-844-3084
Practice Address - Street 1:1495 S COUNTY FARM RD APT 2-3
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-1763
Practice Address - Country:US
Practice Address - Phone:630-844-2662
Practice Address - Fax:630-844-3084
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health