Provider Demographics
NPI:1528149093
Name:VALERIO, MOLLY A (ADTR, LCSW, BCD)
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:A
Last Name:VALERIO
Suffix:
Gender:F
Credentials:ADTR, LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751461
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1461
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:171 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-0100
Practice Address - Country:US
Practice Address - Phone:843-792-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0113731041C0700X
SC98501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232773OtherBLUE CROSS & BLUE SHIELD
IL169389000OtherMAGELLAN HEALTH CARE
IL7242160OtherAETNA
IL001873988004OtherUNITED HEALTH CARE
IL1528149093OtherNATIONAL PROVIDER IDENTIF
IL265480OtherMHN
IL511428OtherVALUE OPTIONS
IL11461659OtherCAQH
IL7242160OtherAETNA