Provider Demographics
NPI:1811582976
Name:MALLEK, KALEIGH SHAYE (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:KALEIGH
Middle Name:SHAYE
Last Name:MALLEK
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:MISS
Other - First Name:KALEIGH
Other - Middle Name:SHAYE
Other - Last Name:ALKIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 VILLAGE GATE BLVD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-8844
Mailing Address - Country:US
Mailing Address - Phone:304-851-7144
Mailing Address - Fax:
Practice Address - Street 1:470 OLDE WORTHINGTON RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9127
Practice Address - Country:US
Practice Address - Phone:614-656-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.20057641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical