Provider Demographics
NPI:1497766075
Name:MOLNAR, MICHELLE L (LMSW, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:L
Last Name:MOLNAR
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:LAPPING-MOLNAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW, ACSW
Mailing Address - Street 1:6024 W MAPLE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4405
Mailing Address - Country:US
Mailing Address - Phone:248-489-1550
Mailing Address - Fax:248-489-9767
Practice Address - Street 1:6024 W MAPLE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4405
Practice Address - Country:US
Practice Address - Phone:248-489-1550
Practice Address - Fax:248-489-9767
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801019798104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION27760Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID