Provider Demographics
NPI:1700577038
Name:THIELKING, MOLLY ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ANNE
Last Name:THIELKING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9286 W QUARTER MOON DR
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:IN
Mailing Address - Zip Code:46064-8633
Mailing Address - Country:US
Mailing Address - Phone:317-362-1783
Mailing Address - Fax:
Practice Address - Street 1:2457 E WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-4182
Practice Address - Country:US
Practice Address - Phone:317-921-0836
Practice Address - Fax:317-204-2715
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.108457104100000X
IN99125807A104100000X
IN34011882A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker