Healthcare Provider Details

I. General information

NPI: 1093636318
Provider Name (Legal Business Name): MOLLY ANN MADDEN LMSW, CBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3965 W 83RD ST
PRAIRIE VILLAGE KS
66208-5308
US

IV. Provider business mailing address

9051 W 121ST PL APT 523
OVERLAND PARK KS
66213-2556
US

V. Phone/Fax

Practice location:
  • Phone: 913-945-1215
  • Fax:
Mailing address:
  • Phone: 773-619-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14856
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: