Provider Demographics
NPI:1265433841
Name:MOLDEN, SABRINA A (PHD)
Entity type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:A
Last Name:MOLDEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10705 HADDINGTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-6954
Mailing Address - Country:US
Mailing Address - Phone:910-494-5800
Mailing Address - Fax:
Practice Address - Street 1:106 LANGTREE VILLAGE DR STE 301
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-7594
Practice Address - Country:US
Practice Address - Phone:704-890-5184
Practice Address - Fax:704-992-9833
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0947103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000649Medicaid
NC6000649Medicaid