Provider Demographics
NPI:1639614407
Name:MCGRAW, MOLLY ANNE ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ANNE ELIZABETH
Last Name:MCGRAW
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 ROWAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-5631
Mailing Address - Country:US
Mailing Address - Phone:951-795-3467
Mailing Address - Fax:
Practice Address - Street 1:1711 ROWAN ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-5631
Practice Address - Country:US
Practice Address - Phone:951-795-3467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
1224381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician