Provider Demographics
NPI:1689011645
Name:DONOVAN, MOLLY
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ARCH ST FL 8
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-7500
Mailing Address - Country:US
Mailing Address - Phone:617-213-6886
Mailing Address - Fax:617-299-8472
Practice Address - Street 1:101 ARCH ST FL 8
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-7500
Practice Address - Country:US
Practice Address - Phone:617-213-6886
Practice Address - Fax:617-299-8472
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health