Molly Josslyn Michau, MSW
Individual provider Active NPI Clinical Social Worker · Represa, CA
NPI 1619128014 · NPPES record last updated Oct 2, 2008
Key facts
- NPI
- 1619128014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 34003597A (IN)
- Practice address
- 300 Prison Rd
Represa, CA 95671-3001 - Phone
- (916) 985-2561
- NPI assigned
- Oct 2, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34003597A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients | |
| Family & Childrens Service of Fort Wayne Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34003597A | IN | Yes |
Addresses
Primary practice location
300 Prison Rd
Represa, CA 95671-3001
Mailing address
1100 Roseville Pkwy
Apt. 314
Roseville, CA 95678-4100
Phone (916) 770-9375
Other providers in Represa, CA
- Timothea Greer McGinley
- Robert Charles McMahon
- Gary J McManus
- Sunny McQuillin
- Brianna Leigh Mead
- Gianna Milazzo
- Michael Milin
- George Gordon Mitchell II
- Abby Molinet-Ramirez
- Thuy T Nguyen
All providers in Represa, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2008. 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.