Provider Demographics
NPI:1518010594
Name:MALONE, PAMELA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:MALONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 W BEN WHITE BLVD
Mailing Address - Street 2:STE. 111
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6888
Mailing Address - Country:US
Mailing Address - Phone:512-444-8889
Mailing Address - Fax:512-326-1527
Practice Address - Street 1:1221 W BEN WHITE BLVD
Practice Address - Street 2:STE. 111
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6888
Practice Address - Country:US
Practice Address - Phone:512-444-8889
Practice Address - Fax:512-326-1527
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX221651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical