Provider Demographics
NPI:1851783773
Name:MCCUNE, MOLLY ANNE (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:MOLLY
Middle Name:ANNE
Last Name:MCCUNE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3176 ABBOTT RD
Mailing Address - Street 2:SUITE 500 BUILDING A
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1069
Mailing Address - Country:US
Mailing Address - Phone:716-822-2117
Mailing Address - Fax:716-822-8165
Practice Address - Street 1:3176 ABBOTT RD
Practice Address - Street 2:SUITE 500 BUILDING A
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1069
Practice Address - Country:US
Practice Address - Phone:716-822-2117
Practice Address - Fax:716-822-8165
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094105104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker