Provider Demographics
NPI:1508502519
Name:MOLLOY, GRACE (LCSW)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:MOLLOY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W 7TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1333
Mailing Address - Country:US
Mailing Address - Phone:215-995-0002
Mailing Address - Fax:
Practice Address - Street 1:3580 INDIAN QUEEN LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1540
Practice Address - Country:US
Practice Address - Phone:215-995-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0225731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical