Provider Demographics
NPI:1134734387
Name:SLOVNIK, MOLLY ELIZABETH (LMSW)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:SLOVNIK
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 1:530 S ASBURY ST STE 4
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-2243
Mailing Address - Country:US
Mailing Address - Phone:208-882-2566
Mailing Address - Fax:888-972-5312
Practice Address - Street 1:530 S ASBURY ST STE 4
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-2243
Practice Address - Country:US
Practice Address - Phone:208-882-2566
Practice Address - Fax:888-972-5312
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-37844104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker