Provider Demographics
NPI:1760403174
Name:MALONE, KATHLEEN KELLY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:KELLY
Last Name:MALONE
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 1:14 HARWOOD CT
Mailing Address - Street 2:SUITE 411
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4121
Mailing Address - Country:US
Mailing Address - Phone:914-723-2084
Mailing Address - Fax:
Practice Address - Street 1:14 HARWOOD CT
Practice Address - Street 2:SUITE 411
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4121
Practice Address - Country:US
Practice Address - Phone:914-723-2084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0283571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical