Provider Demographics
NPI:1598389587
Name:MALOWNEY, MADELINE ROSE (LPCC)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:ROSE
Last Name:MALOWNEY
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 1:5200 WILLSON RD STE 445
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-2303
Mailing Address - Country:US
Mailing Address - Phone:612-787-2344
Mailing Address - Fax:
Practice Address - Street 1:5200 WILLSON RD STE 445
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-2303
Practice Address - Country:US
Practice Address - Phone:612-787-2344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2507101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional