Myrta Ivis Molina

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LGP10535 Issued in MD

Practice address

610 E Diamond Ave Ste 100a
Gaithersburg, MD 20877-5321

Phone

(301) 300-9278

NPI assigned

Jan 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Services, Inc

  • Child & Adolescent Psychiatry Physician
  • Gaithersburg, MD
  • NPI 1780641928

  DC

  Medicare reassignment NPD
• Mosaic Community Services, Inc.

  • Adult Mental Health Clinic/Center
  • Timonium, MD
  • NPI 1265539142
  Medicare reassignment NPD
• Encourage Counseling LLC

  • Mental Health Counselor
  • Gaithersburg, MD
  • NPI 1770361776
  NPD Authorized official
• Way Station, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
  • NPI 1124490784
  Medicare reassignment
• Family Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gaithersburg, MD
  • NPI 1881218816
  NPD
• Mosaic Community Services, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gaithersburg, MD
  • NPI 1710466313
  NPD
• Mosaic Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
  • NPI 1104570167
  NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1992411201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18717 CALYPSO PL",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208791552",
            "telephone_number": "301-300-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E DIAMOND AVE STE 100A",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208775321",
            "telephone_number": "301-300-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "MYRTA",
        "middle_name": "IVIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP10535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Charlene Mobley, LCSW-C
• Modern Eyes, LLC
• Modyfi Health Inc
• Patrice Narda Gaye Moffatt, CCC-SLP
• Aida Mohammadi, DDS
• James Mond
• Antony Alexis Mondragon
• Pascal Mongo
• Tonya Bequita Monroe
• Audrey Monserrate, LMSW

• Professional Counselor in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.