Provider Demographics
NPI:1710157946
Name:HARVEY, MOLLY W (LCSW-LADC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:W
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LCSW-LADC
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:J
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LADC
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:SOUTH THOMASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04858-0123
Mailing Address - Country:US
Mailing Address - Phone:207-542-2558
Mailing Address - Fax:207-800-4955
Practice Address - Street 1:315 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-3388
Practice Address - Country:US
Practice Address - Phone:207-542-2558
Practice Address - Fax:207-800-4955
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC4525101YA0400X
MELC137961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME104000000Medicaid
ME432855899Medicaid