Provider Demographics
NPI:1710785340
Name:MUNIZ, MOLLY JEAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:JEAN
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 GOODNIGHT TRL
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8404
Mailing Address - Country:US
Mailing Address - Phone:817-583-0805
Mailing Address - Fax:
Practice Address - Street 1:601 STRADA CIR # 109
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3212
Practice Address - Country:US
Practice Address - Phone:817-583-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX665591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical