Molli Brunsvold

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3136 Golf Ridge Blvd
Douglasville, GA 30135-1952

Phone

(877) 288-4760

NPI assigned

Jun 14, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Dogwood Autism Services, LLC

  • Behavior Analyst
  • Atlanta, GA
  • NPI 1437674587
  NPD (past)

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1174366405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 GOLF RIDGE BLVD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 GOLF RIDGE BLVD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351952",
            "telephone_number": "877-288-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSVOLD",
        "first_name": "MOLLI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phaedra Rochelle Brown
• Shaleak Brown
• Tanyetta Michelle Brown, FNP
• Emily Ann Brumfield, RN
• Lorna Natalie Bruno, BA
• Bryant Counseling Services, LLC
• Karl Eric Bryant Jr.
• Katrina Mansfield Bryant
• Leonard Bryant
• Lillie R Bryant, RN

• Behavior Technician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.