Provider Demographics
NPI:1558667022
Name:MALONEY, BRIAN (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:MALONEY
Suffix:
Gender:M
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 LANGSTON RD
Mailing Address - Street 2:
Mailing Address - City:CARBON HILL
Mailing Address - State:AL
Mailing Address - Zip Code:35549-3114
Mailing Address - Country:US
Mailing Address - Phone:205-471-5388
Mailing Address - Fax:205-924-8600
Practice Address - Street 1:1608 LANGSTON RD
Practice Address - Street 2:
Practice Address - City:CARBON HILL
Practice Address - State:AL
Practice Address - Zip Code:35549-3114
Practice Address - Country:US
Practice Address - Phone:205-471-5388
Practice Address - Fax:205-924-8600
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2349C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL179500Medicaid
AL179500Medicaid