Provider Demographics
NPI:1174631857
Name:MALONE, DEBORAH J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:MALONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:MALONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:635 JEAN MARIE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5111
Mailing Address - Country:US
Mailing Address - Phone:405-329-7364
Mailing Address - Fax:
Practice Address - Street 1:921 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:405-270-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical