Provider Demographics
NPI:1861749715
Name:ASBURY, MOLLY MARIE (MSW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MARIE
Last Name:ASBURY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 ALMOND DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4020
Mailing Address - Country:US
Mailing Address - Phone:850-980-9017
Mailing Address - Fax:
Practice Address - Street 1:2408 ALMOND DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4020
Practice Address - Country:US
Practice Address - Phone:850-980-9017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLSW117881041C0700X
TX1103001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health