Provider Demographics
NPI:1447376074
Name:ESTERL-BYRNE, MOLLY L (LCSW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:L
Last Name:ESTERL-BYRNE
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 1:80 GARDEN CTR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7087
Mailing Address - Country:US
Mailing Address - Phone:720-263-7516
Mailing Address - Fax:
Practice Address - Street 1:80 GARDEN CTR
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7087
Practice Address - Country:US
Practice Address - Phone:720-263-7516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO989761104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07000771Medicaid
COC008894Medicare PIN
COCOA105752Medicare PIN
CO07000771Medicaid
CO008894OtherKAISER COMMERCIAL NUMBER