Provider Demographics
NPI:1588984892
Name:SELBY, MOLLY MICHELLE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MICHELLE
Last Name:SELBY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 W CHESTNUT ST STE 425
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4537
Mailing Address - Country:US
Mailing Address - Phone:724-206-9996
Mailing Address - Fax:
Practice Address - Street 1:90 W CHESTNUT ST STE 425
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4537
Practice Address - Country:US
Practice Address - Phone:724-206-9996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0102301041C0700X
PACW0189761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical