Provider Demographics
NPI:1043399488
Name:MALINSKI, MARTHA KATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:KATHERINE
Last Name:MALINSKI
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 1:3906 N LAMAR BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4025
Mailing Address - Country:US
Mailing Address - Phone:512-940-4477
Mailing Address - Fax:512-458-2848
Practice Address - Street 1:3906 N LAMAR BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4025
Practice Address - Country:US
Practice Address - Phone:512-940-4477
Practice Address - Fax:512-458-2848
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
610905Medicare ID - Type Unspecified