Provider Demographics
NPI:1518060185
Name:MALONE, BOBBY LEE (MS MSW AAMFT LBSW)
Entity Type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:LEE
Last Name:MALONE
Suffix:
Gender:M
Credentials:MS MSW AAMFT LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-1016
Mailing Address - Country:US
Mailing Address - Phone:256-770-7339
Mailing Address - Fax:256-770-7338
Practice Address - Street 1:114 W 10TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-5614
Practice Address - Country:US
Practice Address - Phone:256-770-7339
Practice Address - Fax:256-770-7338
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51095649MALOtherBCBS