Provider Demographics
NPI:1417058736
Name:MALONEY, PATRICK RAYMOND (LCSW, CACIII)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:RAYMOND
Last Name:MALONEY
Suffix:
Gender:M
Credentials:LCSW, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5931 MIDDLEFIELD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2862
Mailing Address - Country:US
Mailing Address - Phone:720-981-3480
Mailing Address - Fax:720-981-3464
Practice Address - Street 1:9200 W CROSS DR STE 510
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-0761
Practice Address - Country:US
Practice Address - Phone:720-981-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3090101YA0400X
CO9910041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO463058Medicare ID - Type Unspecified