Provider Demographics
NPI:1003878828
Name:MALAMENT, DENISE GAIL (MSW)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:GAIL
Last Name:MALAMENT
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 1:81 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3595
Mailing Address - Country:US
Mailing Address - Phone:978-607-4468
Mailing Address - Fax:
Practice Address - Street 1:81 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3595
Practice Address - Country:US
Practice Address - Phone:978-607-4468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1004601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P03178Medicare ID - Type Unspecified