Individual provider Active NPI

Molly Jean Faulk, L.I.S.W.

  • Addiction (Substance Use Disorder) Counselor
  • Saint Clairsville, OH
National Provider Identifier
1093965444
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
I0800036 Issued in OH
Practice address
255 W Main St
Saint Clairsville, OH 43950-1040
Phone
(740) 695-9447
Fax
(740) 695-8895
NPI assigned
Sep 23, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X I0800036 OH Primary
Clinical Social Worker 1041C0700X I0800036 OH

Addresses

Primary practice location

255 W Main St
Saint Clairsville, OH 43950-1040

Mailing address

PO Box 118
Saint Clairsville, OH 43950-0118
Phone (740) 695-9447

Other identifiers 1

IdentifierTypeStateIssuer
24-01MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
I0800036OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Counseling Services, Inc. CurrentSince Oct 8, 2023 Accepting new patients
Crossroads Counseling Services, Inc. PastSince Jul 24, 2022 Accepting new patients

Locations

255 W Main St
St Clairsvle, OH 43950
Phone (740) 283-7869

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093965444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 118",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439500118",
            "telephone_number": "740-695-9447",
            "fax_number": "740-695-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W MAIN ST",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439501040",
            "telephone_number": "740-695-9447",
            "fax_number": "740-695-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "MOLLY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "I0800036",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0800036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24-01",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clairsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.