Healthcare Provider Details

I. General information

NPI: 1891113148
Provider Name (Legal Business Name): MOLLY BRITTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOLLY LAVANWAY

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SIXTH ST
TRAVERSE CITY MI
49684-2345
US

IV. Provider business mailing address

400 HOBART ST
CADILLAC MI
49601-2331
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-6880
  • Fax: 231-935-6873
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301114133
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: