Provider Demographics
NPI:1477347185
Name:FAHEY, MOLLY MCGILL
Entity type:Individual
Prefix:MISS
First Name:MOLLY
Middle Name:MCGILL
Last Name:FAHEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SHADOW GREEN DR APT 11201
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-4058
Mailing Address - Country:US
Mailing Address - Phone:615-934-2317
Mailing Address - Fax:
Practice Address - Street 1:1897 GENERAL GEORGE PATTON DR STE 108
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6232
Practice Address - Country:US
Practice Address - Phone:615-591-3244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-23-287467106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician