Provider Demographics
NPI:1568654382
Name:MALONEY, JILL IRVINE (LPCC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:IRVINE
Last Name:MALONEY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6539
Mailing Address - Country:US
Mailing Address - Phone:304-281-2757
Mailing Address - Fax:
Practice Address - Street 1:496 NATIONAL ROAD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6539
Practice Address - Country:US
Practice Address - Phone:304-281-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0007488 SUPR101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional