Healthcare Provider Details

I. General information

NPI: 1922625334
Provider Name (Legal Business Name): MOLLY SEXTON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MOLLY SLAVEN, HAUGER

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W BROADWAY
COUNCIL BLUFFS IA
51503-9019
US

IV. Provider business mailing address

PO BOX 157
PORTSMOUTH IA
51565-0157
US

V. Phone/Fax

Practice location:
  • Phone: 712-256-7511
  • Fax:
Mailing address:
  • Phone: 712-579-5819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number100983
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: