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General NPI Number Information
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NPI Number | 1255946653
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Entity Type | Individual
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Provider Name | MOLLY MCBRIDE BROWN LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 6991 N STATE ST
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City | REDWOOD VALLEY
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State | CA
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Zip | 95470-9629
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Country | US
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Telephone | 707-485-5115
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Fax | 707-485-5199
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Provider Business Mailing Address
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Address Line | 511 DELLA AVE
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City | WILLITS
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State | CA
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Zip | 95490-4616
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Country | US
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Telephone | 707-489-3539
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12893
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 124263
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License Number State | CA
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