Active NPI
Carlie Mae Molitsky, MS CCC-SLP
- Speech-Language Pathologist
- La Jose, PA
National Provider Identifier
1467020099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL00129
- Practice address
- 4065 Punkin Ridge Rd
La Jose, PA 15753-7330 - Phone
- (814) 553-9808
- NPI assigned
- Jun 10, 2021
- Last updated
- Jun 10, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL00129 | PA | Primary |
Addresses
Primary practice location
4065 Punkin Ridge Rd
La Jose, PA 15753-7330
Mailing address
4065 Punkin Ridge Rd
La Jose, PA 15753-7330
Phone (814) 553-9808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8145539808 | Other | PHONE NUMBER |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL00129 | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1467020099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4065 PUNKIN RIDGE RD",
"city": "LA JOSE",
"state": "PA",
"postal_code": "157537330",
"telephone_number": "814-553-9808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4065 PUNKIN RIDGE RD",
"city": "LA JOSE",
"state": "PA",
"postal_code": "157537330",
"telephone_number": "814-553-9808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLITSKY",
"first_name": "CARLIE",
"middle_name": "MAE",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-10",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL00129",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHONE NUMBER",
"identifier": "8145539808",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in La Jose, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.