Provider Demographics
NPI:1902873508
Name:MOLZ, CATHERINE WINGFIELD (LCSWC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:WINGFIELD
Last Name:MOLZ
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 HIGH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1307
Mailing Address - Country:US
Mailing Address - Phone:410-778-0234
Mailing Address - Fax:410-778-2665
Practice Address - Street 1:315 HIGH STREET
Practice Address - Street 2:SUITE 105
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1307
Practice Address - Country:US
Practice Address - Phone:410-778-0234
Practice Address - Fax:410-778-2665
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08547104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD201946OtherMEDICARE PTAN
MD5600693 00Medicaid
MD5600693 00Medicaid
R98784Medicare UPIN