1366839664 NPI number — MOLLY MEYER LMSW

Table of content: MOLLY MEYER LMSW (NPI 1366839664)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366839664 NPI number — MOLLY MEYER LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEYER
Provider First Name:
MOLLY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILLER
Provider Other First Name:
MOLLY
Provider Other Middle Name:
STEPHENS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1366839664
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1113 MURFREESBORO RD
Provider Second Line Business Mailing Address:
SUITE 319
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37064-1306
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-790-0567
Provider Business Mailing Address Fax Number:
615-595-8030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1113 MURFREESBORO RD
Provider Second Line Business Practice Location Address:
SUITE 319
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37064-1306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-790-0567
Provider Business Practice Location Address Fax Number:
615-595-8030
Provider Enumeration Date:
04/24/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)