Provider Demographics
NPI:1760812168
Name:CLAREY, MOLLY
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:CLAREY
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 1:1517 JOE MANN BLVD STE 1003
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-8902
Mailing Address - Country:US
Mailing Address - Phone:989-600-3119
Mailing Address - Fax:989-794-6050
Practice Address - Street 1:713 ASHMAN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4996
Practice Address - Country:US
Practice Address - Phone:989-600-3119
Practice Address - Fax:989-794-6050
Is Sole Proprietor?:No
Enumeration Date:2013-11-21
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional