Provider Demographics
NPI:1114480878
Name:MALECK THERAPY, LLC
Entity Type:Organization
Organization Name:MALECK THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, LMFT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MALECK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:608-514-1625
Mailing Address - Street 1:700 RAY O VAC DR STE 320
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2471
Mailing Address - Country:US
Mailing Address - Phone:608-514-1625
Mailing Address - Fax:
Practice Address - Street 1:700 RAYOVAC DR
Practice Address - Street 2:SUITE 320
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:262-224-8799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-10
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)