Provider Demographics
NPI:1609099662
Name:MALAMOOD, HELAYNE (LCSW)
Entity Type:Individual
Prefix:
First Name:HELAYNE
Middle Name:
Last Name:MALAMOOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 N STATION PLZ
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5011
Mailing Address - Country:US
Mailing Address - Phone:516-967-5595
Mailing Address - Fax:
Practice Address - Street 1:45 N STATION PLZ
Practice Address - Street 2:SUITE 202
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5011
Practice Address - Country:US
Practice Address - Phone:516-967-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0249171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7400307OtherGHI PROVIDER NUMBER
NYN1B682OtherEMPIRE PROVIDER NUMBER
NY210985OtherMHN PROVIDER NUMBER
NY093061OtherVALUE OPTIONS PROVIDER #
NYN1B682OtherEMPIRE PROVIDER NUMBER