Provider Demographics
NPI:1285635755
Name:MALAZICH, LORI ANN (LCSW)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANN
Last Name:MALAZICH
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 1:4 ALLEGHENY CTR
Mailing Address - Street 2:8TH FL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5255
Mailing Address - Country:US
Mailing Address - Phone:412-330-4000
Mailing Address - Fax:412-330-4366
Practice Address - Street 1:4 ALLEGHENY CTR
Practice Address - Street 2:8TH FL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5255
Practice Address - Country:US
Practice Address - Phone:412-330-4000
Practice Address - Fax:412-330-4366
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW012594L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015457690001Medicaid
PA1015457690001Medicaid