Provider Demographics
NPI:1861650673
Name:MALONEY, WILLIAM GERARD (MSW/LICSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GERARD
Last Name:MALONEY
Suffix:
Gender:M
Credentials:MSW/LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W SUPERIOR ST
Mailing Address - Street 2:1121
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1701
Mailing Address - Country:US
Mailing Address - Phone:218-590-3909
Mailing Address - Fax:218-733-5669
Practice Address - Street 1:324 W SUPERIOR ST
Practice Address - Street 2:1121
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1701
Practice Address - Country:US
Practice Address - Phone:218-590-3909
Practice Address - Fax:218-733-5669
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN58271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical