Provider Demographics
NPI:1689758450
Name:MALONE, LARRY (MA, LPC)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:MALONE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11702B GRANT RD # 422
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2983
Mailing Address - Country:US
Mailing Address - Phone:713-922-6751
Mailing Address - Fax:713-463-7181
Practice Address - Street 1:9525 KATY FWY STE 312
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1467
Practice Address - Country:US
Practice Address - Phone:713-463-9449
Practice Address - Fax:713-463-7181
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16987101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional