Michael Christopher Molloy, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Wallington, NJ

NPI 1992869697 · NPPES record last updated Dec 17, 2010

Key facts

NPI
1992869697
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC04746300 (NJ)
Practice address
87 Miller St
Suite #1
Wallington, NJ 07057-2209
Phone
(201) 933-5766
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

87 Miller St
Wallington, NJ 07057-2209
Phone (201) 933-5766

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050408000439 NJ Practitioner - Clinical Social Worker 9638116965 Practice locations: Wallington, NJ

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
055883-1NYMDSocial Worker
44SC04746300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Associates LLP Past Accepting new patients
Premier Counseling Services Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 055883-1 NY
Clinical Social Worker 1041C0700X 44SC04746300 NJ Yes

Addresses

Primary practice location

87 Miller St
Suite #1
Wallington, NJ 07057-2209

Mailing address

87 Miller St
Suite #1
Wallington, NJ 07057-2209
Phone (201) 933-5766

Other providers in Wallington, NJ

All providers in Wallington, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.