Provider Demographics
NPI:1871898718
Name:PAINTER, MOLLY O (MED, LPC U/S)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:O
Last Name:PAINTER
Suffix:
Gender:F
Credentials:MED, LPC U/S
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:O
Other - Last Name:MOUNCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:417 E CHEROKEE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5333
Mailing Address - Country:US
Mailing Address - Phone:918-424-5814
Mailing Address - Fax:
Practice Address - Street 1:417 E CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5333
Practice Address - Country:US
Practice Address - Phone:918-424-5814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health