Provider Demographics
NPI:1538705124
Name:MALONE, ROBIN GAIL (LPC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:GAIL
Last Name:MALONE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16603 SANDY LN
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-6758
Mailing Address - Country:US
Mailing Address - Phone:615-397-5669
Mailing Address - Fax:
Practice Address - Street 1:1230 SLAUGHTER RD. STE. E
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3575
Practice Address - Country:US
Practice Address - Phone:256-694-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4410101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1538705124OtherINDEPENDENT INSURANCE COMPANIES