Provider Demographics
NPI:1619523289
Name:MOLINA, MANUEL ANGEL (LMSW)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:ANGEL
Last Name:MOLINA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 49TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2010
Mailing Address - Country:US
Mailing Address - Phone:347-504-3595
Mailing Address - Fax:
Practice Address - Street 1:514 49TH ST FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2010
Practice Address - Country:US
Practice Address - Phone:347-504-3595
Practice Address - Fax:718-238-3862
Is Sole Proprietor?:No
Enumeration Date:2019-08-10
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099357104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker