Provider Demographics
NPI:1265244776
Name:GOBEL, MOLLY
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:GOBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 STOKES AVE SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-1525
Mailing Address - Country:US
Mailing Address - Phone:347-693-3903
Mailing Address - Fax:
Practice Address - Street 1:1820 THE EXCHANGE SE STE 750
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2088
Practice Address - Country:US
Practice Address - Phone:770-769-2796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty