Provider Demographics
NPI:1598281362
Name:MALONE, ERIN LYNN (MS, CRC, LPC, SAC)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:LYNN
Last Name:MALONE
Suffix:
Gender:F
Credentials:MS, CRC, LPC, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 DECORAH RD
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-9598
Mailing Address - Country:US
Mailing Address - Phone:262-483-9085
Mailing Address - Fax:
Practice Address - Street 1:555 S INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-2338
Practice Address - Country:US
Practice Address - Phone:262-483-9085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10612-125101YM0800X
WI17064-131101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)