Mollie Rose Churchill, LCSW
Social Worker, Clinical in Newington, CT. Individual provider (NPI-1).
NPI number1306356373
StatusActive
Last updated in NPPESOct 29, 2019
Details
- NPI
- 1306356373
- Entity type
- Individual (NPI-1)
- Name
- Mollie Rose Churchill
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 4, 2017
- Last updated
- Oct 29, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 10090 | CT | Yes |
Practice location
555 Willard AveNewington, CT 06111-2631
Phone 917-202-0603
Mailing address
555 Willard AveNewington, CT 06111-2631
Phone 917-202-0603
Other practice locations
311 Wyman Park Dr
Baltimore, MD 21211-2804
Baltimore, MD 21211-2804
Phone 917-202-0603
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