Individual provider Active NPI

Elizabeth Mollnow, PH.D.

  • Clinical Psychologist
  • Cary, NC
National Provider Identifier
1972913648
Registry record updated Aug 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4828 Issued in NC
Practice address
1616 Evans Rd
Suite 202
Cary, NC 27513-9653
Phone
(919) 629-6100
NPI assigned
May 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3196 OH
Clinical Psychologist 103TC0700X 4828 NC Primary

Addresses

Primary practice location

1616 Evans Rd
Suite 202
Cary, NC 27513-9653

Mailing address

1616 Evans Rd
Suite 202
Cary, NC 27513-9653
Phone (919) 629-6100

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4828NCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471046400000",
    "number": "1972913648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 EVANS RD",
            "address_2": "SUITE 202",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275139653",
            "telephone_number": "919-629-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 EVANS RD",
            "address_2": "SUITE 202",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275139653",
            "telephone_number": "919-629-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLNOW",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2016-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3196",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2016; 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.