Provider Demographics
NPI:1700386927
Name:MALECEK, JESSICA (MA, LMFT-T)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MALECEK
Suffix:
Gender:F
Credentials:MA, LMFT-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 CENTER POINT RD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-6571
Mailing Address - Country:US
Mailing Address - Phone:319-378-1199
Mailing Address - Fax:
Practice Address - Street 1:1221 CENTER POINT RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6571
Practice Address - Country:US
Practice Address - Phone:319-378-1199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA082804101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health