Provider Demographics
NPI:1275355836
Name:DANA, MOLLY (LCISW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:DANA
Suffix:
Gender:F
Credentials:LCISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 31ST ST NW STE 312
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-6042
Mailing Address - Country:US
Mailing Address - Phone:812-447-3705
Mailing Address - Fax:
Practice Address - Street 1:1054 31ST ST NW STE 312
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-6042
Practice Address - Country:US
Practice Address - Phone:812-447-3705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000035601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical