Healthcare Provider Details

I. General information

NPI: 1679811301
Provider Name (Legal Business Name): MOLLY MALLOY CHEEK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2013
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 WESTOVER HILLS BLVD
RICHMOND VA
23225-4434
US

IV. Provider business mailing address

PO BOX 28526
RICHMOND VA
23228-8526
US

V. Phone/Fax

Practice location:
  • Phone: 855-444-9838
  • Fax:
Mailing address:
  • Phone: 804-285-9838
  • Fax: 804-285-9839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904004049
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: