Provider Demographics
NPI:1275314395
Name:MOLLY BRUENING LLC
Entity Type:Organization
Organization Name:MOLLY BRUENING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL INDEPENDENT SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUENING
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-943-2603
Mailing Address - Street 1:1715 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-1762
Mailing Address - Country:US
Mailing Address - Phone:515-943-2603
Mailing Address - Fax:
Practice Address - Street 1:939 OFFICE PARK RD STE 200
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2538
Practice Address - Country:US
Practice Address - Phone:515-943-2603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty