Provider Demographics
NPI:1043685670
Name:LININGER, MOLLY B
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:B
Last Name:LININGER
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 1:421 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-7920
Mailing Address - Country:US
Mailing Address - Phone:269-861-3596
Mailing Address - Fax:
Practice Address - Street 1:1125 E MILHAM AVE STE B
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-3096
Practice Address - Country:US
Practice Address - Phone:269-312-1446
Practice Address - Fax:269-775-1079
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2021-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010953911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical