Provider Demographics
NPI:1225757628
Name:MOLINA INTERVENTIONS LLC
Entity type:Organization
Organization Name:MOLINA INTERVENTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LPC-S
Authorized Official - Phone:915-217-4648
Mailing Address - Street 1:12649 KATHERINE BRENNAND RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-5892
Mailing Address - Country:US
Mailing Address - Phone:915-217-4648
Mailing Address - Fax:915-201-0944
Practice Address - Street 1:1200 GOLDEN KEY CIR STE 121
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-5813
Practice Address - Country:US
Practice Address - Phone:915-500-0944
Practice Address - Fax:915-201-0944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty