Provider Demographics
NPI:1558597252
Name:MCCARTNEY, MOLLY (MSW)
Entity Type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:
Last Name:MCCARTNEY
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 1:1120 SANDY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:WV
Mailing Address - Zip Code:26440-7614
Mailing Address - Country:US
Mailing Address - Phone:304-265-0389
Mailing Address - Fax:
Practice Address - Street 1:1120 SANDY CREEK RD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:WV
Practice Address - Zip Code:26440-7614
Practice Address - Country:US
Practice Address - Phone:304-265-0389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSW04912018104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1558597252Medicaid