Provider Demographics
NPI:1598958126
Name:MALONEY, MEGAN E (LMSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:MALONEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11228 SILVER DR
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-9784
Mailing Address - Country:US
Mailing Address - Phone:810-938-3586
Mailing Address - Fax:
Practice Address - Street 1:11228 SILVER DR
Practice Address - Street 2:
Practice Address - City:WHITMORE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48189-9784
Practice Address - Country:US
Practice Address - Phone:810-938-3586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010915031041C0700X
MIC-02651101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI7093OtherMEDICARE PTAN