Provider Demographics
NPI:1881431393
Name:LYNNEA MOLINA, LCSW
Entity type:Organization
Organization Name:LYNNEA MOLINA, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNNEA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:518-588-0207
Mailing Address - Street 1:248 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4375
Mailing Address - Country:US
Mailing Address - Phone:518-588-0207
Mailing Address - Fax:
Practice Address - Street 1:4032 ALTAMONT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2604
Practice Address - Country:US
Practice Address - Phone:518-588-0207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty