Provider Demographics
NPI:1568833325
Name:MOLLY PERRY COUNSELING, P.C.
Entity type:Organization
Organization Name:MOLLY PERRY COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:BENOIT
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:612-432-3525
Mailing Address - Street 1:4749 CHICAGO AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-3556
Mailing Address - Country:US
Mailing Address - Phone:612-432-3525
Mailing Address - Fax:188-852-6723
Practice Address - Street 1:4749 CHICAGO AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3556
Practice Address - Country:US
Practice Address - Phone:612-432-3525
Practice Address - Fax:188-852-6723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00554101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty