Provider Demographics
NPI:1073691457
Name:ISAACSON, MOLLIE ESTHER (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MOLLIE
Middle Name:ESTHER
Last Name:ISAACSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 HORSESHOE CURV
Mailing Address - Street 2:
Mailing Address - City:PIKE ROAD
Mailing Address - State:AL
Mailing Address - Zip Code:36064-3408
Mailing Address - Country:US
Mailing Address - Phone:334-244-9738
Mailing Address - Fax:
Practice Address - Street 1:660 HORSESHOE CURV
Practice Address - Street 2:
Practice Address - City:PIKE ROAD
Practice Address - State:AL
Practice Address - Zip Code:36064-3408
Practice Address - Country:US
Practice Address - Phone:334-244-9738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0916C-LCSW-PIP1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00042726Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER