Provider Demographics
NPI:1912561887
Name:PALLAVICINI, MOLLY ELIZABETH (LPC)
Entity Type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:PALLAVICINI
Suffix:
Gender:F
Credentials:LPC
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Mailing Address - Street 1:ROCKBRIDGE AREA HEALTH CENTER
Mailing Address - Street 2:25 NORTHRIDGE LANE
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450
Mailing Address - Country:US
Mailing Address - Phone:540-464-8700
Mailing Address - Fax:540-464-1323
Practice Address - Street 1:ROCKBRIDGE AREA HEALTH CENTER
Practice Address - Street 2:25 NORTHRIDGE LANE
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450
Practice Address - Country:US
Practice Address - Phone:540-464-8700
Practice Address - Fax:540-464-1323
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0701008218101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional