Mary Molly Loren Pruit

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2240 Issued in KS

Practice address

3425 W Central Ave
Wichita, KS 67203-4919

Phone

(316) 946-0990

Fax

(316) 943-1139

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Molly L Traffas Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emberhope, Inc

  • Physical Disabilities Residential Treatment Facility
  • Newton, KS
  • NPI 1265439871

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1104884154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034919",
            "telephone_number": "316-946-0990",
            "fax_number": "316-943-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034919",
            "telephone_number": "316-946-0990",
            "fax_number": "316-943-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUIT",
        "first_name": "MARY MOLLY",
        "middle_name": "LOREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "2240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100457290B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "070415",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "TRAFFAS",
            "middle_name": "L",
            "credential": "LSCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Providence Home Health & Hospice LLC.
• Providence Physical Therapy
• Jessica Lynn Provines, TLMLP
• Macey Pruett, OD
• Micaela Elizabeth Pruiett, LPC
• Lou Ann Prusa, LCMFT
• John C Pryor, LCPC, LPC
• Psych Credentialing
• Psych-Aprn, LLC
• Psyche and Soul, LLC

• Clinical Social Worker in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.