Provider Demographics
NPI:1578692299
Name:MALONE, JOHN HAL III (MS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HAL
Last Name:MALONE
Suffix:III
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WALNUT CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3682
Mailing Address - Country:US
Mailing Address - Phone:615-824-0954
Mailing Address - Fax:
Practice Address - Street 1:108 WALNUT CT
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3682
Practice Address - Country:US
Practice Address - Phone:615-824-0954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNNONE101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional