Blancandrea Quetzali Molina, LPCC
Individual provider Active NPI Mental Health Counselor · Kelseyville, CA
NPI 1245099068 · NPPES record last updated Mar 14, 2024
Key facts
- NPI
- 1245099068
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPCC15659 (CA)
- Practice address
- 2210 Smith LN
Kelseyville, CA 95451-9162 - Phone
- (808) 457-8257
- NPI assigned
- Mar 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC15659 | CA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPCC15659 | CA | Yes |
Addresses
Primary practice location
2210 Smith LN
Kelseyville, CA 95451-9162
Mailing address
2210 Smith LN
Kelseyville, CA 95451-9162
Phone (808) 457-8257
Other providers in Kelseyville, CA
- Michael Maravich
- Mary Theresa McMillan
- Eunice M Mentges
- Scott Richard Meyer
- Latisha Miles
- Zabdy Martinez Neria
- North Coast Faculty Medical Group
- Nurturing Healthy Minds
- Ian Palmer
- Levi Samuel Palmer
All providers in Kelseyville, CA · Mental Health Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.