Stanley, Molly Dana
Stanley, Molly Dana is an sole proprietor health care provider with primary practice located at 345 Cottage Rd , South Portland ME 04106-3919. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Stanley, Molly Dana can be contacted via phone (207) 799-2099.Contact Information
Primary practice address
345 Cottage Rd
South Portland ME 04106-3919
Phone: (207) 799-2099
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1185 | Maine |
Profile Details
| NPI number | 1487634473 |
|---|---|
| LBN Legal business name | Stanley, Molly Dana |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 18th, 2006 |
| Last updated | Nov 9th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487634473 | NPPES |
| Maine | Other | 11540840 | CAQH |
| Maine | Other | 008414 | CAQH |
| Maine | MEDICAID | 010424754 | CAQH |
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