Provider Demographics
NPI:1851009609
Name:SMALL, MALAIKA A (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MALAIKA
Middle Name:A
Last Name:SMALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 LORING PL S APT 4E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-2923
Mailing Address - Country:US
Mailing Address - Phone:917-805-9823
Mailing Address - Fax:
Practice Address - Street 1:1944 LORING PL S APT 4E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-2923
Practice Address - Country:US
Practice Address - Phone:917-805-9823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118071-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health