Molly Bracken, M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP005359 Issued in GA

Practice address

311 Cooper Rd
Loganville, GA 30052-4976

Phone

(678) 205-5437

NPI assigned

Oct 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Kidsplay Therapy Center, Inc.

  • Specialist
  • Loganville, GA
  • NPI 1619054319
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222041600000",
    "number": "1437235488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 COOPER RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524976",
            "telephone_number": "678-205-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 COOPER RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524976",
            "telephone_number": "678-205-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "MOLLY",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009945728A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesty Boby, FNP-C
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• Miranda Bollinger
• Jennifer K Bolton, DC
• Karene Gaile Boone, NP
• Monica L Branson, OTR/L
• Breathon Medical Inc
• Brian Dempsey OD LLC
• Corina Bridges
• Leslie C. Bridges, PT

• All providers in Loganville, GA
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; 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.