Provider Demographics
NPI:1417632969
Name:MALONE, DAWN (LSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:MALONE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-4626
Mailing Address - Country:US
Mailing Address - Phone:732-742-3549
Mailing Address - Fax:
Practice Address - Street 1:15 FARVIEW TER STE 1
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2762
Practice Address - Country:US
Practice Address - Phone:551-579-4441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL069304001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical