Provider Demographics
NPI:1679788533
Name:MOLLY COGGINS
Entity type:Organization
Organization Name:MOLLY COGGINS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR LPC
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:FOWLKES
Authorized Official - Last Name:COGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-329-7460
Mailing Address - Street 1:1590 CONSTITUTION BLVD # 01
Mailing Address - Street 2:BLDG C
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3004
Mailing Address - Country:US
Mailing Address - Phone:803-329-7460
Mailing Address - Fax:803-328-3840
Practice Address - Street 1:1590 CONSTITUTION BLVD # 01
Practice Address - Street 2:BLDG C
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3004
Practice Address - Country:US
Practice Address - Phone:803-329-7460
Practice Address - Fax:803-328-3840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2434101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty