Provider Demographics
NPI:1679691695
Name:MALENBAUM, INEZ (LPC)
Entity Type:Individual
Prefix:MS
First Name:INEZ
Middle Name:
Last Name:MALENBAUM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 MARLTON PIKE E STE V105
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4101
Mailing Address - Country:US
Mailing Address - Phone:856-751-0505
Mailing Address - Fax:
Practice Address - Street 1:1930 MARLTON PIKE E STE V105
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4101
Practice Address - Country:US
Practice Address - Phone:856-751-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003575101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional