Provider Demographics
NPI:1851137129
Name:MCGREGOR, MOLLY
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 QUARTZ WAY
Mailing Address - Street 2:
Mailing Address - City:MOUND HOUSE
Mailing Address - State:NV
Mailing Address - Zip Code:89706-7054
Mailing Address - Country:US
Mailing Address - Phone:775-350-9511
Mailing Address - Fax:
Practice Address - Street 1:2621 NORTHGATE LN
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-1653
Practice Address - Country:US
Practice Address - Phone:775-884-2269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-24281041C0700X
NV9389-M1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool