Provider Demographics
NPI:1326694837
Name:HISEL, MOLLY CAITLIN (CSW)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:CAITLIN
Last Name:HISEL
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 MARIE LANGDON DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-6329
Mailing Address - Country:US
Mailing Address - Phone:606-599-4080
Mailing Address - Fax:606-598-0983
Practice Address - Street 1:56 MARIE LANGDON DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-6329
Practice Address - Country:US
Practice Address - Phone:606-599-4080
Practice Address - Fax:606-598-0983
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator