Individual provider · Type 1 NPI

Molly Marie Theodore

Mental Health Counselor · Corvallis, OR

NPI number 1154928422 Active

Practice location

4185 SW Research Way
Corvallis, OR 97333-1783

Call (541) 766-6767 Map

Fax (541) 766-6186

Mailing address

PO Box 579
Corvallis, OR 97339-0579

Specialties and licenses

TaxonomyCodeLicense
Behavior Technician 106S00000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed
Case Manager/Care Coordinator 171M00000XNone listed

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About NPI 1154928422

Molly Marie Theodore's National Provider Identifier is 1154928422, issued on Oct 8, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Corvallis, OR. The record was last updated on Apr 29, 2026.