Active NPI
Julie Lynne Mollica, LICENSED INDEPENDENT
- Clinical Social Worker
- Brewster, MA
National Provider Identifier
1669972790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1029770
- Practice address
- 456 Flax Pond Road
Brewster Treatment Program, Old Colony YMCA
Brewster, MA 02631 - Phone
- (508) 896-9700
- Fax
- (508) 896-8706
- NPI assigned
- Feb 15, 2018
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1029770 | MA | Primary |
Addresses
Primary practice location
456 Flax Pond Road
Brewster Treatment Program, Old Colony YMCA
Brewster, MA 02631
Mailing address
456 Flax Pond Road
Brewster Treatment Program, Old Colony YMCA
Brewster, MA 02631
Phone (508) 896-9700
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1029770 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1669972790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "456 FLAX POND ROAD",
"address_2": "BREWSTER TREATMENT PROGRAM, OLD COLONY YMCA",
"city": "BREWSTER",
"state": "MA",
"postal_code": "02631",
"telephone_number": "508-896-9700",
"fax_number": "508-896-8706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "456 FLAX POND ROAD",
"address_2": "BREWSTER TREATMENT PROGRAM, OLD COLONY YMCA",
"city": "BREWSTER",
"state": "MA",
"postal_code": "02631",
"telephone_number": "508-896-9700",
"fax_number": "508-896-8706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLLICA",
"first_name": "JULIE",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "LICENSED INDEPENDENT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1029770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brewster, MA
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.