Provider Demographics
NPI:1437660602
Name:MALLOY, EMILY CATHERINE (LMSW; JD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CATHERINE
Last Name:MALLOY
Suffix:
Gender:F
Credentials:LMSW; JD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:CATHERINE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 RIVERSIDE DR APT 111
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4160
Mailing Address - Country:US
Mailing Address - Phone:917-848-6386
Mailing Address - Fax:
Practice Address - Street 1:325 RIVERSIDE DR APT 111
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4160
Practice Address - Country:US
Practice Address - Phone:917-848-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101083104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker