Basic Information
Provider Information
NPI: 1750886891
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NOLTE
FirstName: MOLLY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 W MARKET ST
Address2:  
City: AKRON
State: OH
PostalCode: 443031411
CountryCode: US
TelephoneNumber: 3305642469
FaxNumber: 3305649296
Practice Location
Address1: 611 W MARKET ST
Address2:  
City: AKRON
State: OH
PostalCode: 443031411
CountryCode: US
TelephoneNumber: 3305642469
FaxNumber: 3305649296
Other Information
ProviderEnumerationDate: 03/29/2018
LastUpdateDate: 03/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XC.1700190OHN Behavioral Health & Social Service ProvidersCounselorProfessional
101YP2500XE.1901568OHY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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