Provider Demographics
NPI:1760203541
Name:CONYERS, MOLLY (LMSW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:CONYERS
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:MOLLIE
Other - Middle Name:
Other - Last Name:CONYERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:2330 N OLIVER ST APT 303
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-2935
Mailing Address - Country:US
Mailing Address - Phone:316-352-7248
Mailing Address - Fax:
Practice Address - Street 1:2330 N OLIVER ST APT 303
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220-2935
Practice Address - Country:US
Practice Address - Phone:316-352-7248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty