Organization
MOLLY JO COUNSELING & ART THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOLLY ANSARI LCPC, ATR (PRESIDENT)
(920) 698-1886
Entity
Organization
Contact information
Practice address
29W170 BUTTERFIELD RD STE 103, WARRENVILLE, IL 60555-2807
(331) 465-1153
Mailing address
3486 WILD PRAIRIE LN, GENEVA, IL 60134-3963
(920) 698-1886
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
180009952
IL
261QM0850X
Adult Mental Health Clinic/Center
180009952
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
180009952
IL
Other
Enumeration date
11/25/2017
Last updated
12/05/2022
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