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Individual

MOLLY ANN VAILLINCOURT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW, MLADC

Contact information

Practice address
1 WASHINGTON ST, DOVER, NH 03820-3848
(603) 945-8390
Mailing address
2 BURNHAM AVE, DURHAM, NH 03824-3011
(603) 892-2699

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1064
NH
101YM0800X
Mental Health Counselor
Primary
2237
NH
1041C0700X
Clinical Social Worker
2237
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3097970
NH
Enumeration date
03/26/2019
Last updated
03/13/2021
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