Provider Demographics
NPI:1710090774
Name:STROSNIDER, MOLLIE ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:ANNE
Last Name:STROSNIDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 BLUEMONT AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-4903
Mailing Address - Country:US
Mailing Address - Phone:540-397-0488
Mailing Address - Fax:
Practice Address - Street 1:2727 ELECTRIC RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3547
Practice Address - Country:US
Practice Address - Phone:540-772-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003992101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor