Provider Demographics
NPI:1972111011
Name:CARTA, MOLLY (LPC)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:
Last Name:CARTA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-5327
Mailing Address - Country:US
Mailing Address - Phone:860-655-8097
Mailing Address - Fax:
Practice Address - Street 1:78 EASTERN BLVD STE 2
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4325
Practice Address - Country:US
Practice Address - Phone:860-652-0428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional