| Molly Vanduser, Lpc | |
|
817 W Front St Lillington NC 27546-9735 | |
| (910) 814-2197 | |
| (910) 814-2167 |
| Full Name | Molly Vanduser, Lpc |
|---|---|
| Speciality | Counselor |
| Location | 817 W Front St, Lillington, North Carolina |
| Authorized Official Name and Position | Molly Lynn Vanduser (PRESIDENT) |
| Authorized Official Contact | 9108142197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Molly Vanduser, Lpc Po Box 2088 817 West Front Street Lillington NC 27546-9735 Ph: (910) 814-2197 | Molly Vanduser, Lpc 817 W Front St Lillington NC 27546-9735 Ph: (910) 814-2197 |
| NPI Number | 1417144106 |
|---|---|
| Provider Enumeration Date | 09/27/2007 |
| Last Update Date | 02/23/2009 |
| Medicare PECOS PAC ID | 4284992827 |
|---|---|
| Medicare Enrollment ID | O20180103000823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417144106 | NPI | - | NPPES |
| 600502017 | Other | NC | MAGELLAN |
| P-130377 | Other | NC | MEDCOST |
| 6006249 | Medicaid | NC | |
| 147JE | Other | NC | BLUE CROSS |
| 370742 | Other | NC | TRICARE PRIME AND STANDARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4963 (North Carolina) | Primary |
| Provider Name | Pamela Bertolino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346360724 PECOS PAC ID: 6002880937 Enrollment ID: I20080424000380 |
| Provider Name | Molly L. Vanduser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659354660 PECOS PAC ID: 1153689799 Enrollment ID: I20240115000097 |
| Provider Name | Donna Marie Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144571795 PECOS PAC ID: 5698127538 Enrollment ID: I20240117000338 |
| Provider Name | Alvin Willfard Martin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558840678 PECOS PAC ID: 1951754514 Enrollment ID: I20240130003384 |
| Provider Name | Harriet Leigh Enzor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699791590 PECOS PAC ID: 6608229083 Enrollment ID: I20240201002632 |
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