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General NPI Number Information
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NPI Number | 1700577038
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Entity Type | Individual
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Provider Name | MOLLY ANNE THIELKING LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2457 E WASHINGTON ST STE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46201-4182
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Country | US
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Telephone | 317-921-0836
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Fax | 317-204-2715
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Provider Business Mailing Address
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Address Line | 9286 W QUARTER MOON DR
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City | PENDLETON
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State | IN
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Zip | 46064-8633
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Country | US
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Telephone | 317-362-1783
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.108457
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 99125807A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34011882A
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License Number State | IN
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