Provider Demographics
NPI:1477876191
Name:MALAVE, SIOBHAN (MSSA, LISW-S)
Entity Type:Individual
Prefix:MS
First Name:SIOBHAN
Middle Name:
Last Name:MALAVE
Suffix:
Gender:F
Credentials:MSSA, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1613
Mailing Address - Country:US
Mailing Address - Phone:216-459-1222
Mailing Address - Fax:216-459-2696
Practice Address - Street 1:2202 PRAME AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1626
Practice Address - Country:US
Practice Address - Phone:216-459-1222
Practice Address - Fax:216-459-2696
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1100175-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical