Individual provider Active NPI

Mollie Lee Braun, MOLLIE BRAUN APRN

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Holyoke, MA
National Provider Identifier
1467518787
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
75897PC Issued in MA
Practice address
489 Whitney Ave
3Rd Floor
Holyoke, MA 01040-2711
Phone
(413) 532-6777
Fax
(413) 532-6744
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 75897PC MA Primary

Addresses

Primary practice location

489 Whitney Ave
3Rd Floor
Holyoke, MA 01040-2711

Mailing address

132 Brickyard Rd
Southampton, MA 01073-9525
Phone (413) 529-9412

Other identifiers 2

IdentifierTypeStateIssuer
PN0807OtherMABCBSMA
1859978OtherMAMASSHEALTH QMB

Other names 1

  • Mollie Lee Freese Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75897PCMAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467518787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 BRICKYARD RD",
            "city": "SOUTHAMPTON",
            "state": "MA",
            "postal_code": "010739525",
            "telephone_number": "413-529-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 WHITNEY AVE",
            "address_2": "3RD FLOOR",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010402711",
            "telephone_number": "413-532-6777",
            "fax_number": "413-532-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "MOLLIE",
        "middle_name": "LEE",
        "credential": "MOLLIE BRAUN APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "75897PC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "PN0807",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH QMB",
            "identifier": "1859978",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLIE",
            "last_name": "FREESE",
            "middle_name": "LEE",
            "credential": "MOLLIE BRAUN APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holyoke, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.