Provider Demographics
NPI:1427388388
Name:MALONE COUNSELING SERVICE, PLLC
Entity Type:Organization
Organization Name:MALONE COUNSELING SERVICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-924-5364
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:155 MAIN ST #C
Mailing Address - City:OROFINO
Mailing Address - State:ID
Mailing Address - Zip Code:83544-0324
Mailing Address - Country:US
Mailing Address - Phone:208-476-4230
Mailing Address - Fax:208-476-4281
Practice Address - Street 1:155 MAIN STREET
Practice Address - Street 2:#C
Practice Address - City:OROFINO
Practice Address - State:ID
Practice Address - Zip Code:83544
Practice Address - Country:US
Practice Address - Phone:208-476-4230
Practice Address - Fax:208-476-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management